Predictors of chemotherapy-induced cardiotoxicity among African American women with breast cancer: A retrospective study.

Abstract

e24002 Background: African American women who were treated for breast cancer with anti-HER2 monoclonal antibody and/or anthracyclines experience an increased risk of cardiotoxicity. However, the factors that are linked to increased cardiotoxicity risk in this population are not fully understood. We evaluated the association between clinical variables and cardiovascular outcomes among African American women with breast cancer who were treated with anti-HER2 mAB and/or anthracyclines in an urban safety net academic hospital in Brooklyn, New York. We aim to identify any potential predictors associated with poor cardiovasclar outcomes in our patient population. Methods: We conducted a retrospective cohort study involving 244 women diagnosed with breast cancer between 2017 and 2023. Inclusion criteria included women aged 18 years and older with a confirmed diagnosis of breast cancer and who had received anti-HER2 mAB, with/without anthracycline and/or radiation therapy. Exclusion criteria included pre-existing cardiovascular disease, including previous coronary artery disease or congestive heart failure. Variables include BMI, menopausal status, presence of diabetes, hypertension, thyroid disease, and the use of statin, ACEi/ARB, or beta blockers. Cardiotoxicity was defined as a composite endpoint, including a more than 15% reduction in the left ventricular ejection fraction from baseline and the development of symptomatic congestive heart failure or myocardial infarction event following the initiation of the chemotherapy. Cardiac function were evaluated by an official TTE or MUGA scan before and every 3 months after initiation of chemotherapy. Unadjusted and adjusted logistic regression models were used to estimate odd ratios (ORs) and 95% confidence intervals (CIs) of cardiotoxicity. Results: Among the 244 African American women treated for breast cancer, the mean age was 54 years (SD 10.6 years). A total of 29 patients (10.2%) experienced cardiotoxicity. Statistical analysis revealed that menopause was significantly associated with an increased risk of cardiotoxicity (OR = 3.04, 95% CI 1.31- 11.11, p = 0.01). Additionally, body mass index was also found to be significantly correlated with cardiotoxicity risk (OR = 1.08, 95% CI: 1.01-1.16, p = 0.03). These association remained significant event after adjusting for potential confounders, with menopause (P = 0.007) and body mass index (p = 0.03) retaining their statistical significance. There was no statistical significant correlation between cardiotoxicity risk and other variables. Conclusions: Out study demonstrated that menopausal status and body mass index were associated with an elevated risk of chemotherapy-induced cardiotoxicity in African American women who underwent treatment in an urban safety net academic hospital in Brooklyn, New York.