Original Article
Hung Yi Chen
Abstract
BACKGROUND: The relationship between infective endocarditis (IE) and malignancies had been reported. However, cancer development is multifactorial and mortality is high in IE survivors. We aimed to estimate the absolute cancer risk in IE survivors and tried to find the potential risk factors. METHODS: This nationwide, population-based cohort study evaluated 8649 newly diagnosed IE who survived after discharge from first hospitalization using the Taiwan National Health Insurance Research Data-base (NHIRD). Propensity score method was used at a 1:1 ratio based on age, gender, income, urbanization level, Charlson comorbidity index (CCI), concomitant medication, and medical history. The primary outcomes were all specific cancer types. All the variables matched for propensity score were analyzed to find their association with cancer occurrence. RESULTS: Compared with the matched cohort, IE survivors increase the risk of cancer (adjusted hazard ratio [aHR], 1.64; 95% confidence interval [CI], 1.39- 1.94), as well as significantly elevated risks of digestive (aHR, 2.27; 95% CI, 1.76- 2.92) and hematologic (aHR, 2.73; 95% CI, 2.31-5.71) malignancies. Age (aHR, 1.47; 95% CI, 1.36-1.57), male (aHR, 1.49; 95% CI, 1.18-1.90), CCI score (aHR, 1.05; 95% CI, 1.01-1.10) are risk factors for cancer occurrence among IE survivors, while aspirin use reduced the cancer risk (aHR, 0.73; 95% CI, 0.54-0.98). CONCLUSION: Our study provides further investigation between IE and cancer risk. In conclusion, cancer risk, particularly digestive and hematologic malignancies, is substantially increased in IE survivors. Our results also provide additional evidence that aspirin use is effective in reducing cancer risk in IE survivors.