Cardiovascular Mortality Risk among Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Registry-Based Analysis

Background The research aimed to explore mortality patterns and quantitatively assess risks of cardiovascular mortality (CVM) in patients with primary gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Methods We extracted data from the Surveillance, Epidemiology and End Results (SEER) database for patients diagnosed with GEP-NENs between 2000 and 2015. Standardized mortality ratio (SMR) and the absolute excess risk were obtain based on the reference of general US population. The cumulative incidence function curves were constructed by all causes of death. Predictors for CVM were identified using multivariate competing risk model. Results Overall, 42027 patients were enrolled from the SEER database, of which 1598 (3.8%) died from cardiovascular disease (CVD). The SMR for CVM was 1.20 (95%CI: 1.14–1.26) among GEP-NENs patients. The cumulative mortality of CVD was the lowest in all causes of death, including primary cancer, other cancer, and other non-cancer disease. Furthermore, age of diagnosis, race, Hispanic origin, gender, marital status, year of diagnosis, grade, education level, region, SEER stage, primary site, surgery and chemotherapy were identified as independent predictors of CVM in GEP-NENs patients. Conclusions GEP-NENs patients have a significantly increased risk of CVM in contrast to the general population. Better cardioprotective interventions might be considered as a preferred method to protect heart for GEP-NENs patients.