Research in context
Evidence before this study
People who have survived cancer are living longer than those with cancer in 1990 but can be at increased risk of cardiovascular disease. The management of cardiovascular disease among people who have not had a cardiovascular disease event is based on their estimated absolute risk of disease, which is measured by cardiovascular disease risk prediction equations. Multiple such equations are available, but most have been developed in general primary care populations. The validity of these equations in survivors of cancer is unclear. Evidence to date has been limited by small numbers of patients or by a focus on a specific cancer type or cardiovascular disease outcome. A 2021 systematic review found that several risk equations had been developed and validated, but only for patients with breast cancer and with a focus on heart failure and cardiomyopathy after cancer treatment.
Added value of this study
This study assessed the performance of the New Zealand cardiovascular disease risk prediction equations, which were developed in a general primary care population, among 14 263 patients from New Zealand with a primary diagnosis of invasive cancer at least 2 years before cardiovascular disease risk assessment. To our knowledge, our study is the first to validate cardiovascular disease risk prediction equations in a broad and large group of survivors of cancer.
Implications of all the available evidence
We found that cardiovascular disease risk prediction equations developed in a New Zealand general primary care population were reasonable clinical tools for use in survivors of cancer in New Zealand for whom the assessment of cardiovascular disease risk was considered clinically appropriate by their primary care clinician. Prediction could be improved by adding cancer-specific variables and considering competing risks. The equations can predict cardiovascular disease risk with reasonable variations from observed risk in survivors of cancer at primary care practices.