Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines
Background Cardiotoxicity in patients with cancer treated with anthracyclines is associated with increased morbidity and mortality. We aimed to examine the incidence of and risk factors for cardiotoxicity in a racially and ethnically diverse cohort with cancer treated with anthracyclines. Methods We...
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Wiley
2025-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037780 |
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| author | Lili Zhang Justin Song Waqas Hanif Rachel Clark Magued Haroun Caroline McNaughton Leandro Slipczuk Mario J. Garcia Min Pu Carlos A. Gongora Tomas G. Neilan Della Makower Charles B. Hall Earle C. Chambers Carlos J. Rodriguez |
| author_facet | Lili Zhang Justin Song Waqas Hanif Rachel Clark Magued Haroun Caroline McNaughton Leandro Slipczuk Mario J. Garcia Min Pu Carlos A. Gongora Tomas G. Neilan Della Makower Charles B. Hall Earle C. Chambers Carlos J. Rodriguez |
| author_sort | Lili Zhang |
| collection | DOAJ |
| description | Background Cardiotoxicity in patients with cancer treated with anthracyclines is associated with increased morbidity and mortality. We aimed to examine the incidence of and risk factors for cardiotoxicity in a racially and ethnically diverse cohort with cancer treated with anthracyclines. Methods We included consecutive adult patients who underwent anthracycline‐based chemotherapy from 2016 to 2019 for any type of cancer. The end point was the development of cardiotoxicity (defined as clinical heart failure or drop in left ventricular ejection fraction ≥10% to ≤50%). Results A total of 743 individuals were included (28.0% Non‐Hispanic [NH] White, 30.5% NH Black, 38.5% Hispanic, 3.0% Asian). Hypertension, diabetes, hyperlipidemia, obesity, and low socioeconomic status were more common in NH Black and Hispanic individuals. During a median follow‐up of 21 months, 98 individuals (13.2%) developed cardiotoxicity. The incidence of cardiotoxicity was significantly higher in NH Black (16.3%), Hispanic (14.7%) and Asian (18.2%) individuals than in NH White (7.2%) individuals (P=0.024). After adjusting for cardiovascular risk factors, socioeconomic status score, anthracycline dose, baseline left ventricular ejection fraction, and cancer type, being NH Black (hazard ratio [HR], 2.62 [95% CI, 1.23–5.56]) or Hispanic (HR, 2.37 [95% CI, 1.11–5.07]) was independently associated with a higher risk of cardiotoxicity. NH Black and Hispanic individuals had a greater decline in left ventricular ejection fraction compared with NH White and Asian counterparts. The associations between baseline characteristics and incident cardiotoxicity were similar across different racial and ethnic groups. Conclusions In a large retrospective multiracial and ethnic cohort treated with anthracyclines, NH Black, Hispanic, and Asian individuals had an increased risk of cardiotoxicity compared with their NH White counterparts. |
| format | Article |
| id | doaj-art-624d0d42944a4f6caa53b1a78b2676b0 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-624d0d42944a4f6caa53b1a78b2676b02025-08-20T03:07:46ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114710.1161/JAHA.124.037780Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With AnthracyclinesLili Zhang0Justin Song1Waqas Hanif2Rachel Clark3Magued Haroun4Caroline McNaughton5Leandro Slipczuk6Mario J. Garcia7Min Pu8Carlos A. Gongora9Tomas G. Neilan10Della Makower11Charles B. Hall12Earle C. Chambers13Carlos J. Rodriguez14Division of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADepartment of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADepartment of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USACardio‐Oncology Program, Cardiovascular Imaging Research Center (CIRC), Department of Radiology and Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston MA USADepartment of Oncology, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USADepartment of Epidemiology & Population Health Albert Einstein College of Medicine Bronx NY USADepartment of Epidemiology & Population Health Albert Einstein College of Medicine Bronx NY USADivision of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USABackground Cardiotoxicity in patients with cancer treated with anthracyclines is associated with increased morbidity and mortality. We aimed to examine the incidence of and risk factors for cardiotoxicity in a racially and ethnically diverse cohort with cancer treated with anthracyclines. Methods We included consecutive adult patients who underwent anthracycline‐based chemotherapy from 2016 to 2019 for any type of cancer. The end point was the development of cardiotoxicity (defined as clinical heart failure or drop in left ventricular ejection fraction ≥10% to ≤50%). Results A total of 743 individuals were included (28.0% Non‐Hispanic [NH] White, 30.5% NH Black, 38.5% Hispanic, 3.0% Asian). Hypertension, diabetes, hyperlipidemia, obesity, and low socioeconomic status were more common in NH Black and Hispanic individuals. During a median follow‐up of 21 months, 98 individuals (13.2%) developed cardiotoxicity. The incidence of cardiotoxicity was significantly higher in NH Black (16.3%), Hispanic (14.7%) and Asian (18.2%) individuals than in NH White (7.2%) individuals (P=0.024). After adjusting for cardiovascular risk factors, socioeconomic status score, anthracycline dose, baseline left ventricular ejection fraction, and cancer type, being NH Black (hazard ratio [HR], 2.62 [95% CI, 1.23–5.56]) or Hispanic (HR, 2.37 [95% CI, 1.11–5.07]) was independently associated with a higher risk of cardiotoxicity. NH Black and Hispanic individuals had a greater decline in left ventricular ejection fraction compared with NH White and Asian counterparts. The associations between baseline characteristics and incident cardiotoxicity were similar across different racial and ethnic groups. Conclusions In a large retrospective multiracial and ethnic cohort treated with anthracyclines, NH Black, Hispanic, and Asian individuals had an increased risk of cardiotoxicity compared with their NH White counterparts.https://www.ahajournals.org/doi/10.1161/JAHA.124.037780anthracyclinecardiotoxicitydisparitiesethnicityrace |
| spellingShingle | Lili Zhang Justin Song Waqas Hanif Rachel Clark Magued Haroun Caroline McNaughton Leandro Slipczuk Mario J. Garcia Min Pu Carlos A. Gongora Tomas G. Neilan Della Makower Charles B. Hall Earle C. Chambers Carlos J. Rodriguez Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease anthracycline cardiotoxicity disparities ethnicity race |
| title | Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines |
| title_full | Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines |
| title_fullStr | Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines |
| title_full_unstemmed | Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines |
| title_short | Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines |
| title_sort | racial and ethnic disparities in cardiotoxicity in patients with cancer treated with anthracyclines |
| topic | anthracycline cardiotoxicity disparities ethnicity race |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037780 |
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