Cardio-oncology & otherCohort study
Fluoropyrimidine Chemotherapy and the Risk of Death and Cardiovascular Events in Patients With Gastrointestinal Cancer
- Observational cohort study (target trial emulation)
- linked national registries
- adjusted, weighted pooled logistic regression
Authors' conclusion
The markedly improved overall survival with fluoropyrimidines in patients with gastrointestinal cancer significantly outweighs the small risk of cardiac arrhythmia and arrest.
Study context
- Population
- Adults with gastrointestinal tumours eligible for first-line fluoropyrimidine-based chemotherapy (Virtual Cardio-Oncology Research Initiative registries)
- Participants
- 103,110 adults
- Exposure
- Fluoropyrimidine-based chemotherapy vs alternative management
- Outcome
- All-cause mortality and composite of hospitalisation for acute CV events (ACS, HF, arrhythmia, cardiac intervention, cardiac arrest, cardiac death)
- Follow-up
- 1 year
Main finding
As reported in the abstract
Fluoropyrimidine vs Alternative managementRD (95% CI)
all-cause death
−7.7%(−8.7% to −6.7%)
acute CV events
0.9%(0.0%–1.9%)
Observational data: associations, not effects.
Further findings
| Outcome | RD (95% CI) | |
|---|---|---|
| Components of acute CV events · 1 year — Fluoropyrimidine vs Alternative management · arrhythmias | 0.8% (0.1%–1.6%) | |
| Components of acute CV events · 1 year — Fluoropyrimidine vs Alternative management · cardiac arrest | 0.3% (0.1%–0.5%) | |
| −1012Difference (linear scale) |
Components of acute CV events · 1 year
- No increased risk of ACS, including in pre-existing CAD subgroup
Original publication
Fluoropyrimidine Chemotherapy and the Risk of Death and Cardiovascular Events in Patients With Gastrointestinal Cancer. JACC CardioOncol. Published 8 April 2025. doi:10.1016/j.jaccao.2025.01.019
Summarised from the published abstract; every number is checked against it