{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:09:46Z","timestamp":1791259786900,"version":"4.1.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"jah39852-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardiovascular disease and cancer share a common risk factor: chronic stress\/allostatic load (AL). A 1\u2010point increase in AL is linked to up to a 30% higher risk of major cardiac events (MACE) in patients with prostate cancer. However, AL's role in MACE in breast cancer, lung cancer, or colorectal cancer remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah39852-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients \u226518\u2009years of age diagnosed with the mentioned 3 cancers of interest (2010\u20132019) and followed up at a large, hybrid academic\u2010community practice were included in this retrospective cohort study. AL was modeled as an ordinal measure (0\u201311). Adjusted Fine\u2013Gray competing risks regressions estimated the impact of AL precancer diagnosis on 2\u2010year MACE (a composite of heart failure, ischemic stroke, acute coronary syndrome, and atrial fibrillation). The effect of AL changes over time on MACE was calculated via piecewise Cox regression (before, and 2\u2009months, 6\u2009months, and 1 year after cancer diagnosis). Among 16\u2009467 patients, 50.5% had breast cancer, 27.9% had lung cancer, and 21.4% had colorectal cancer. A 1\u2010point elevation in AL before breast cancer diagnosis corresponded to a 10% heightened associated risk of MACE (adjusted hazard ratio, 1.10 [95% CI, 1.06\u20131.13]). Similar findings were noted in lung cancer (adjusted hazard ratio, 1.16 [95% CI, 1.12\u20131.20]) and colorectal cancer (adjusted hazard ratio, 1.13 [95% CI, 1.08\u20131.19]). When considering AL as a time\u2010varying exposure, the peak associated MACE risk occurred with a 1\u2010point AL rise between 6 and 12 months post\u2010 breast cancer, lung cancer, and colorectal cancer diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah39852-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">AL warrants investigation as a potential marker in these patients to identify those at elevated cardiovascular risk and intervene accordingly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.033295","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T07:56:34Z","timestamp":1720511794000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Allostatic Load\/Chronic Stress and Cardiovascular Outcomes in Patients Diagnosed With Breast, Lung, or 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