Enfermedades cardiovasculares y diagnóstico

Results of a Population-Based Cohort Study on Heart Disease Risk Following Breast Cancer Treatment

Abstract

Haomin Yang

Introduction: Concerns about treatment-related cardiotoxicities in breast cancer patients are growing. The purpose of this study was to ascertain the time- and treatment-specific incidence of ischemic heart disease, heart failure, and arrhythmia in breast cancer patients.

Methods: Stockholm-Gotland breast cancer patients diagnosed between 2001 and 2008 were included in a register-based matched cohort study that was followed up until 2017.Flexible parametric models were used to compare breast cancer patients' time-dependent risks of arrhythmia, heart failure, and ischemic heart disease to those of matched controls from the general population. The Cox model was used to estimate treatmentspecific effects in breast cancer patients.

Results: After being diagnosed with breast cancer, time-dependent analyses revealed an increased risk of heart failure and arrhythmia in the long run. Peril proportions (HRs) inside the principal year of conclusion were 2.14 (95% CI=1.63-2.81) for arrhythmia and 2.71 (95% CI=1.70-4.33) for cardiovascular breakdown. For arrhythmia, the HR was 1.42 (95% CI=1.21–1.67), while for heart failure, it was 1.28 (95% CI=1.03–1.59) after 10 years. Only in the first year following diagnosis did the risk of ischemic heart disease rise significantly (HR=1.45, 95% CI=1.03–2.04). Trastuzumab and anthracyclines were related with expanded hazard of cardiovascular breakdown. Ischemic heart disease was linked to the risk of aromatase inhibitors, but not tamoxifen. Following locoregional radiotherapy, there was no evidence of an increased risk of heart disease.

Conclusion: Systemic adjuvant therapies appear to be linked to a higher risk of heart disease. In oncology settings, decision-making regarding adjuvant therapy and patient counselling may be aided by the risk estimates found in this study.