Strategies to achieve racial equity in cardio-oncology care for women with ovarian cancer.

Abstract

e24028 Background: Ovarian cancer (OC) remains the most lethal gynecologic malignancy, despite significant advancements in treatment that have led to improvements in survival rates. The current standard of care, which often involves a platinum-based chemotherapy regimen combined with a taxane, is associated with an elevated risk of major adverse cardiovascular and cerebrovascular events (MACCE). Our research aims to identify racial disparities in the care provided to OC patients to promote more equitable treatment options for women across all racial and ethnic groups. Methods: Patients with ovarian cancer were identified using ICD-10 codes from the 2022 National Inpatient Sample database, which compiles hospitalization records from across the United States. The study focused on ovarian cancer patients who were admitted with a primary diagnosis of acute myocardial infarction (AMI), congestive heart failure (CHF) exacerbation, or acute cerebrovascular accident (CVA). We excluded patients with elective hospitalizations and those diagnosed with other malignancies. Baseline characteristics, including demographic information and comorbidities, were analyzed alongside MACCE outcomes. Statistical analysis was performed using chi-square tests, with a significance threshold set at p < 0.05. The overall mortality rate and adjusted odds ratios were further stratified by patient race. Results: A total of 35,949 ovarian cancer patients were included in the study, with the following racial distribution: 68.34% (24,150) White, 12.36% (4,369) Black, 11.78% (4,164) Hispanic, 4.13% (1,460) Asian, 0.66% (240) Native American, and 2.72% (959) from other racial groups. Among these patients, those hospitalized for an acute stroke had nearly double the mortality rate compared to the general population (8.9% vs. 4.8%, p = 0.04). When compared to White patients, Black ovarian cancer patients had a higher all-cause in-hospital mortality (ACIHM), with an adjusted odds ratio (aOR) of 1.22 (95% CI 1.04 - 1.39, p = 0.03). Conclusions: The study revealed that outcomes of MACCE were poorer in non-White women with OC. This highlights the urgent need for better allocation of resources to address these disparities. The findings emphasize the importance of integrating cardio-oncology services throughout the management of women with OC, particularly those undergoing chemotherapy with a high risk of cardiotoxicity.