Increment in Oncovascular Risk Factors and Psychological Distress and Unaltered Vascular Endothelial Function with Advancement of the Stages in Newly Diagnosed Patients with Primary Breast Cancer

Abstract

Abstract Background and Aims Oncovascular risk factors are common to both cardiovascular diseases and cancer. Adipocytokines, cell adhesion molecules, and psychological distress may have roles in disease progression. Materials and Methods Eighty subjects including healthy control and patients of different stages of newly diagnosed breast cancer were recruited. The levels of psychological distress, oncovascular risk factors, and endothelial function were estimated. Results Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), adiponectin, and scores of anxiety (Generalized Anxiety Disorder-7 [GAD-7]), depression (Patient Health Questionnaire-9 [PHQ-9]), and perceived stress (Perceived Stress Scale [PSS]) increased with increasing stages of the disease. Vascular endothelial function (brachial artery flow-mediated dilation) among the different stages and healthy controls was comparable. Adiponectin (area under the curve [AUC] = 0.755 at 1.66 µg/mL, sensitivity 70% and specificity 80%), sICAM-1 (AUC = 0.769 at 264 pg/mL, sensitivity 80% and specificity 75%), and sVCAM-1 (AUC = 0.934 at 165 ng/mL, sensitivity 88% and specificity 85%) are useful in the breast cancer diagnosis with receiver operating characteristic curves. PSS (r = 0.688, p < 0.001), PHQ-9 (r = 0.633, p < 0.001), GAD-7 scores (r = 0.674, p < 0.001) and levels of sICAM-1 (r = 0.480, p < 0.001) and sVCAM-1 (r = 0.577, p < 0.00) correlated with disease progression. Perceived stress had maximum independent association with the disease progression. Oncovascular risk factors correlated with perceived stress, anxiety, and depression. Conclusion Increment in oncovascular risk factors, psychological distress, and their associations were observed with increasing stages of breast cancer. Intervention to prevent incidence of coronary heart diseases and appropriate psychological counseling for patients with breast cancer may be considered for bringing forth better treatment outcome.