Abstract 12791: Examining the Association Between Socioeconomic Factors and Left Ventricular Ejection Fraction Declines in Breast Cancer and Lymphoma Survivors Receiving Doxorubicin: WF-98213

Abstract

Introduction: Breast cancer and lymphoma survivors who have received doxorubicin are at risk of experiencing a decline in left ventricular ejection fraction (LVEF), yet whether socioeconomic factors further impact this decline is unknown. Methods: We performed a secondary analysis of data from a double-blinded clinical trial (NCT01988571) in breast cancer and lymphoma survivors that determined the impact of statin use on LVEF 6- and 24-months following initiation of doxorubicin. LVEF was measured via magnetic resonance imaging. Socioeconomic factors were collected via survey. Linear regression models assessed relationships between socioeconomic variables and change in LVEF from baseline to 24 months by individuals blinded to treatment group. Results: Of the 279 survivors included in this analysis, a majority were white (82.8%) (13.6% Black, 3.6% other races), college educated (56.3%), and employed (63.8%). Mean LVEF at baseline was 62.2% (SD=6.01) and mean LVEF declines at 6- and 24-months were 4.72% (SD=7.30) and 5.11% (SD=7.20), respectively. In the multivariable model, after controlling for age, race, body mass index, and smoking, patients who made >$75k per year had a significantly smaller LVEF drop (3.36, 95% CI: -0.53, 7.25) at 6-months than patients making less than <$35k per year (8.66, 95% CI: 4.87, 12.45), p =0.003. Employed patients making >$75k per year had significantly smaller LVEF declines (mean=5.00, 95% CI: 0.14, 9.86) than employed patients making less than 35k per year (mean=9.43, 95% CI: 4.30, 14.56), p=0.033. Lastly, employed patients making >75k had a marginally significantly lower EF drop than unemployed patients making >75k per year (mean=7.83, 95%CI: 3.32, 12.34), p=0.092. These findings occurred independent of statin use. Conclusions: Findings from this study highlight a need to understand how one’s socioeconomic status (SES), or in terms of social determinants of health, economic stability, may serve as a protective factor regarding LVEF decline during treatment with doxorubicin for breast cancer and lymphoma. Future work should also consider examining the association between SES and care delivery and how that may potentially impact LVEF decline.