Do Young Kim1, Jong-Chan Youn2, Myung-Soo Park3, Sunki Lee3, Suk-Won Choi3, Kyu-Hyung Ryu3, Lee Su Kim4, Man-Shik Shim5, Jae Jin Lee6, Seongwoo Han7. 1. Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea; Division of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea. 2. Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. Electronic address: jong.chan.youn@gmail.com. 3. Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. 4. Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. 5. Department of Thoracic and Cardiovascular Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea. 6. Department of Thoracic and Cardiovascular Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea. Electronic address: jj58lee@hallym.or.kr. 7. Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. Electronic address: hansw29@hallym.or.kr.
Abstract
BACKGROUND: Cancer treatment increases the risk of cardiovascular (CV) events. However, the long-term CV outcome of breast cancer patients who undergo radiotherapy and chemotherapy concomitantly is unknown. This study aimed to determine the incidence and risk factors of CV events among these patients. METHODS: Six hundred sixty consecutive breast cancer patients older than 50 years from November 2005 to September 2015, were enrolled in four university hospitals. The primary endpoint was CV events including CV mortality, myocardial infarction, heart failure, and stroke. CV events occurred in 14 (2.1%) patients during the follow-up period (median, 47.1 months). RESULTS: Left-side irradiation was associated with increased risk of CV events in patients with doxorubicin dose ≥250mg/m2 but not in patients with doxorubicin dose <250mg/m2. On multivariable analysis, concomitant left-side irradiation with doxorubicin dose ≥250mg/m2 and hypertension were independent risk factors for CV events. CONCLUSION: The risk of CV events was further increased with concomitant left-side irradiation and doxorubicin ≥250mg/m2 in breast cancer patients.
BACKGROUND: Cancer treatment increases the risk of cardiovascular (CV) events. However, the long-term CV outcome of breast cancerpatients who undergo radiotherapy and chemotherapy concomitantly is unknown. This study aimed to determine the incidence and risk factors of CV events among these patients. METHODS: Six hundred sixty consecutive breast cancerpatients older than 50 years from November 2005 to September 2015, were enrolled in four university hospitals. The primary endpoint was CV events including CV mortality, myocardial infarction, heart failure, and stroke. CV events occurred in 14 (2.1%) patients during the follow-up period (median, 47.1 months). RESULTS: Left-side irradiation was associated with increased risk of CV events in patients with doxorubicin dose ≥250mg/m2 but not in patients with doxorubicin dose <250mg/m2. On multivariable analysis, concomitant left-side irradiation with doxorubicin dose ≥250mg/m2 and hypertension were independent risk factors for CV events. CONCLUSION: The risk of CV events was further increased with concomitant left-side irradiation and doxorubicin ≥250mg/m2 in breast cancerpatients.
Authors: Lauren E Carlson; Gordon P Watt; Emily S Tonorezos; Eric J Chow; Anthony F Yu; Meghan Woods; Charles F Lynch; Esther M John; Lene Mellemkjӕr; Jennifer D Brooks; Julia A Knight; Anne S Reiner; Xiaolin Liang; Susan A Smith; Leslie Bernstein; Lawrence T Dauer; Laura I Cerviño; Rebecca M Howell; Roy E Shore; John D Boice; Jonine L Bernstein Journal: JACC CardioOncol Date: 2021-09-21