Abstract
Background: Women with breast cancer (BC) represent a special population particularly exposed to cardiovascular disease (CVD) risk. However, cardiologic assessment in BC is mostly limited to detection of left ventricular dysfunction cardiotoxicity (LVD-CTX) due to anticancer treatments. Our aim was to comprehensively investigate CV profile and events in a contemporary BC cohort.Methods and Results: Records of BC patients referred for a Cardio-Oncologic evaluation before starting anticancer treatments, between 2016 and 2019, were retrospectively reviewed (n = 508). Information regarding prevalence and control of CV risk factors, and novel CVD diagnoses were extracted. Occurrence of LVD-CTX, CV events other than LVD-CTX and mortality was assessed. Mean age of study population was 64 ± 13 years; 287 patients were scheduled to receive anthracycline and 165 anti-HER2 therapy. Overall, 53% of BC women had ≥2 CV risk factors, and 67% had at least one of arterial hypertension, dyslipidaemia or diabetes mellitus not adequately controlled. Eighteen (4%) patients were diagnosed a previously unknown CVD. Over a mean follow-up of 2.5 ± 1 years, 3% of BC patients developed LVD-CTX, 2% suffered from other CV events and 11% died. CV risk factors were not associated with LVD-CTX, except for family history of CAD. On the contrary, patients with other CV events exhibited a worse CV profile. Those who died more commonly experienced CV events other than LVD-CTX (p = 0.02).Conclusions: BC women show a suboptimal CV risk profile and are at risk of CV events not limited to LVD-CTX. A baseline Cardio-Oncologic evaluation was instrumental to implement CV prevention and to optimize CV therapies.
Highlights
Women with breast cancer (BC) represent a special population exposed to cardiovascular disease (CVD) risk
As traditional CV risk factors predispose to cardiotoxicity [9], and to adverse outcomes after oncologic treatment in cancer survivors [10], the need for CV prevention in oncology has emerged as another important issue [11]
We retrospectively reviewed the records of all BC patients referred for a Cardio-Oncologic evaluation before starting anticancer treatment at the IRCCS Ospedale Policlinico San Martino Cardio-Oncology Outpatient Clinic between 1st January, 2016 and 15th June, 2019
Summary
Women with breast cancer (BC) represent a special population exposed to cardiovascular disease (CVD) risk. Cardiologic assessment in BC is mostly limited to detection of left ventricular dysfunction cardiotoxicity (LVD-CTX) due to anticancer treatments. Patients with breast cancer (BC) represent a special female population exposed to CV risk [2]. Various analyses have highlighted how CVD is becoming a leading threat for health in BC patients, especially in Cardiovascular Health of Breast-Cancer Women individuals older than 65 years or with pre-existing CV conditions [3,4,5]. In common clinical practice, a focus on CV health in BC women is not routinely undertaken, and cardiologic involvement has been mostly dedicated to cardiotoxicity due to anticancer treatments. Integrated data about these diverse aspects of Cardio-Oncology practice are limited
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