Abstract PO-098: Cardioprotective medication use in hormone receptor positive breast cancer survivors

Abstract

Abstract Introduction: Cardiovascular diseases (CVD), including treatment-related cardiotoxicity, are problematic for breast cancer survivors, particularly Black women. Prevention and management of CV-related morbidity, including uptake of cardioprotective medication such as angiotensin converting enzyme inhibitors (ACEi) or ß-Blocker (BB), is a priority for many breast cancer survivors. We assessed the prevalence of cardioprotective medication use in survivors and identified factors associated with use by race. Methods: This was a secondary analysis of data from the Women’s Hormonal Initiation and Persistence (WHIP) study, a longitudinal observational trial of women diagnosed with hormone receptor positive breast cancer prescribed adjuvant endocrine therapy. The primary outcome, ACEi/BB use was dichotomized as yes versus no and based on pharmacy records. Demographic, psychosocial (e.g. discrimination), healthcare (e.g. provider communication), and quality of life factors (e.g. functional well-being) were collected from patient surveys. Clinicopathologic variables were abstracted from medical records. Bivariate associations by race and ACEi/BB use were assessed using chi square and t-tests while three logistic regression analyses were used assess multivariable associations between predictors and ACEi/BB use in all women and stratified by race. Results: Of the 246 survivors, 33.3% were Black, 58.4% were <65 years of age, and 64.3%.3% were diagnosed with stage I disease. Fifty-seven percent of women had hypertension and 33.3% received ACEi/BBs. In bivariate analysis, ACEi/BB use was significantly more common among Black women, those with hypertension, and women who experienced discrimination. In unadjusted logistic regression models, White women (vs. Black) (OR: 0.33, 95% CI: 0.19-0.58) and women with higher ratings of functional wellbeing (OR: 0.94, 95% CI: 0.89-0.00) were less likely to use ACEi/BBs. Women ≥65 and those with hypertension were more likely to use ACEi/BBs. Satisfaction with provider communication was a significant predictor of medication use for White women. In logistic regression models adjusted for age and race, race was not associated with ACEi/BB use (OR: 0.50, 95% CI: 0.21-1.17). Odds of ACEi/BB use were highest amongst women with hypertension and, for Black women only, in women >65. Conclusions: CVD contributes to poorer outcomes in breast cancer survivors, particularly in Black women. Future studies on CVD management and prevention practices and the roles of psychosocial and healthcare factors on ACEi/BB adherence are warranted. Citation Format: Arnethea L. Sutton, Ashley S. Felix, Vanessa B. Sheppard. Cardioprotective medication use in hormone receptor positive breast cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-098.