Association of Anthracycline With Heart Failure in Patients Treated for Breast Cancer or Lymphoma, 1985-2010

Key Points Question What is the long-term incidence of heart failure (HF) in patients with cancer treated with anthracyclines in a population-based sample? Findings In this case-control study among 2196 individuals, including 812 participants with cancer and 1384 control participants, the cumulative incidence of HF in participants with cancer treated with anthracycline was 7.4% over 15 years, more than 2 times higher than in matched controls, and was not significant for a subgroup of participants with cancer not treated with anthracycline compared with controls. The shift in risk was observed during the first year of follow-up and persisted over the follow-up period. Meaning These findings suggest that anthracycline treatment in patients with cancer was associated with more than twice the risk of HF compared with controls.

[1]  G. Boriani,et al.  2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). , 2022, European heart journal.

[2]  C. Iribarren,et al.  Risk of Cardiovascular Disease in Women With and Without Breast Cancer: The Pathways Heart Study , 2022, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  J. Cerhan,et al.  Anthracycline treatment, cardiovascular risk factors and the cumulative incidence of cardiovascular disease in a cohort of newly diagnosed lymphoma patients from the modern treatment era , 2021, American journal of hematology.

[4]  Jeroen J. Bax,et al.  Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio‐Oncology Council of the European Society of Cardiology (ESC) , 2020, European journal of heart failure.

[5]  J. Herrmann.  Adverse cardiac effects of cancer therapies: cardiotoxicity and arrhythmia , 2020, Nature Reviews Cardiology.

[6]  K. Bhaskaran,et al.  Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases , 2019, The Lancet.

[7]  T. El‐Galaly,et al.  Cumulative anthracycline exposure and risk of cardiotoxicity; a Danish nationwide cohort study of 2440 lymphoma patients treated with or without anthracyclines , 2018, British journal of haematology.

[8]  A. Vickers,et al.  Preexisting Cardiovascular Risk and Subsequent Heart Failure Among Non-Hodgkin Lymphoma Survivors. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[9]  S. Pressler,et al.  Functional status and quality of life among breast cancer survivors with heart failure: results of the Medicare Health Outcomes Survey , 2017, Supportive Care in Cancer.

[10]  J. Herrmann.  Tyrosine Kinase Inhibitors and Vascular Toxicity: Impetus for a Classification System? , 2016, Current Oncology Reports.

[11]  B. Dietrich.  Cancer Epidemiology And Prevention , 2016 .

[12]  M. Espié,et al.  Cardiac toxicity events in the PHARE trial, an adjuvant trastuzumab randomised phase III study. , 2015, European journal of cancer.

[13]  J. Raemaekers,et al.  Cardiovascular disease after Hodgkin lymphoma treatment: 40-year disease risk. , 2015, JAMA internal medicine.

[14]  L. Allen,et al.  Performance of Claims-based Algorithms for Identifying Heart Failure and Cardiomyopathy Among Patients Diagnosed With Breast Cancer , 2014, Medical care.

[15]  A. Abbate,et al.  Review and meta-analysis of incidence and clinical predictors of anthracycline cardiotoxicity. , 2013, The American journal of cardiology.

[16]  S. Wann,et al.  Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. , 2013, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[17]  B. Yawn,et al.  History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population. , 2012, Mayo Clinic proceedings.

[18]  Scott M. Brue,et al.  Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system. , 2012, International journal of epidemiology.

[19]  A. Goldhirsch,et al.  Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[20]  L. Allen,et al.  Risk of Heart Failure in Breast Cancer Patients After Anthracycline and Trastuzumab Treatment: A Retrospective Cohort Study , 2012, Journal of the National Cancer Institute.

[21]  B. Yawn,et al.  Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project. , 2012, Mayo Clinic proceedings.

[22]  B. Yawn,et al.  American Journal of Epidemiology Practice of Epidemiology Use of a Medical Records Linkage System to Enumerate a Dynamic Population over Time: the Rochester Epidemiology Project , 2022 .

[23]  Michael S. Ewer,et al.  Cardiotoxicity of anticancer treatments: what the cardiologist needs to know , 2010, Nature Reviews Cardiology.

[24]  R. Murphy,et al.  Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study , 2010, Heart.

[25]  Xianglin L. Du,et al.  Cardiac toxicity associated with anthracycline‐containing chemotherapy in older women with breast cancer , 2009, Cancer.

[26]  E. Yeh,et al.  Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. , 2009, Journal of the American College of Cardiology.

[27]  Torben Skovsgaard,et al.  New insight into epirubicin cardiac toxicity: competing risks analysis of 1097 breast cancer patients. , 2008, Journal of the National Cancer Institute.

[28]  W. Tsai,et al.  Doxorubicin, cardiac risk factors, and cardiac toxicity in elderly patients with diffuse B-cell non-Hodgkin's lymphoma. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[29]  Greg Yothers,et al.  Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[30]  L. Melton,et al.  Potential effect of authorization bias on medical record research. , 1999, Mayo Clinic proceedings.

[31]  K. Bailey,et al.  Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. , 1998, Circulation.

[32]  B. Yawn,et al.  The impact of requiring patient authorization for use of data in medical records research. , 1998, The Journal of family practice.

[33]  H. Lynch,et al.  Psychologic Aspects of Cancer Genetic Testing: A Research Update for Clinicians , 1997 .

[34]  K. Bailey,et al.  The incidence and prevalence of congestive heart failure in Rochester, Minnesota. , 1993, Mayo Clinic proceedings.