Arterial stiffness in long-term breast cancer survivors: a propensity score–matched analysis in primary prevention
摘要
Breast cancer treatment may be associated with adverse cardiovascular effects. Pulse wave velocity (PWV) is a marker of arterial stiffness and a validated predictor of cardiovascular events. The aim of this study was to evaluate whether a history of breast cancer (HBC), beyond the first year after diagnosis, is associated with higher PWV in middle-aged women in a primary prevention setting.
MethodsWomen aged 35 to 65 years evaluated at a cardiometabolic unit between September 2021 and March 2024 were included if valid PWV measurements obtained by automated oscillometry were available. Exclusion criteria comprised previous cardiovascular disease, chronic kidney disease stage > II, and inflammatory conditions. Participants were categorized according to HBC, defined as a diagnosis made at least one year prior to evaluation. A propensity score adjusted for age, hypertension, dyslipidemia, smoking status, physical inactivity, diabetes, obesity and use of statins was constructed, and 1:1 matching was performed. PWV (m/s) was the primary outcome. In addition, inverse probability weighting (IPW) analysis was conducted.
ResultsA total of 2,318 women were analyzed (mean age 51.0 ± 7.3 years); 53 (2.3%) had HBC, with a median time of 67 months since diagnosis. PWV was significantly higher in women with HBC compared with those without cancer (7.85 ± 0.99 vs. 7.34 ± 1.09 m/s; p = 0.0008), with no significant differences in traditional cardiovascular risk factors. After matching, HBC was associated with a 0.34 m/s increase in PWV (95% CI: 0.24–0.45; p < 0.001). IPW analysis confirmed these findings.
ConclusionsA history of breast cancer is associated with increased arterial stiffness independently of traditional risk factors, underscoring the relevance of vascular surveillance in breast cancer survivors.