Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study
In: Frontiers in Oncology, 2234-943X, 2023, 13; orcid:0000-0002-6578-8826; PMID 37152049; ISI:000979166300001; Scopus 2-s2.0-85159910100
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Zugriff:
BackgroundThe administration of anticancer drugs in females with comorbidity increases the risk for cancer therapy-related cardiovascular toxicity (CTR-CVT), which in turn contributes to cardiovascular disease (CVD). Furthermore, a pathophysiological connection between cancer and cardiovascular disease may exist. ObjectiveTo assess the long-term risks and predictors of CTR-CVT, including clinical hypertension (HT), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), as well as all-cause mortality in women diagnosed with early breast cancer (BC) and eligible for adjuvant chemotherapy in Sweden. MethodsData were extracted from Swedish registers and medical records on 433 women, 18-60 years of age, diagnosed 1998-2002 with lymph node-positive BC, and considered for adjuvant chemotherapy. CTR-CVT was defined as HT, CAD, HF, or AF after the diagnosis of BC. Follow-up was from the date of BC diagnosis until November 30, 2021, or death. Prevalence of CTR-CVT and all-cause mortality were calculated. Hazard ratios (HR) were determined for factors associated with CTR-CVT. ResultsThe median age was 50 (interquartile range (IQR) 32) years. 910 CTR-CVT events were diagnosed in 311 women with a median of 19.3 (IQR 15,3) years follow-up. The proportions of CTR-CVT events were: HT 281 (64%); CAD 198 (46%); HF 206 (47%); and AF 225 (51%). The cumulative incidence of CTR-CVT was 71.8%, and 50% of all 433 patients developed CTR-CVT within 11.7 years of BC diagnosis (standard deviation (SD) 0.57, 95% confidence interval (CI) 10.6-12.9). Age was a risk factor for CTR-CVT. Anthracycline increased the risk for HF (p=0,001; HR 2,0; 95%CI 1,4-2,8), CAD (p= 0,002; HR 1,7; 95% CI 1,2-2,4), and AF (p=0,013; HR 1,5; 95% CI 1,0-2,0). At the end of the 24-year study period, 227 of the 433 women were alive, and the total cumulative mortality was 47,6%. ConclusionThe prevalence of CTR-CVT and all-cause mortality is high after BC diagnosis and treatment, particularly in older patients and those receiving anthracyclines. ...
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Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study
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Autor/in / Beteiligte Person: | Hübbert, Laila ; Mallios, Panagiotis ; Karlström, Patric ; Papakonstantinou, Andri ; Bergh, Jonas ; Hedayati, Elham |
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Quelle: | Frontiers in Oncology, 2234-943X, 2023, 13; orcid:0000-0002-6578-8826; PMID 37152049; ISI:000979166300001; Scopus 2-s2.0-85159910100 |
Veröffentlichung: | Linköpings universitet, Avdelningen för diagnostik och specialistmedicin ; Linköpings universitet, Medicinska fakulteten ; Region Östergötland, Kardiologiska kliniken i Norrköping ; Ryhov Cty Hosp, Sweden ; Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden; Comprehens Canc Ctr, Sweden ; FRONTIERS MEDIA SA, 2023 |
Medientyp: | academicJournal |
ISBN: | 978-0-00-979166-6 (print) ; 0-00-979166-3 (print) |
DOI: | 10.3389/fonc.2023.1095251 |
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