Incidence of Cancer Therapy-Related Cardiac Dysfunction in Māori Versus Non-Māori Patients

Abstract

Survival disparities continue to exist between Māori and non-Māori patients across most cancers. This study investigated whether there were higher rates of cancer therapy-related cardiac dysfunction (CTRCD) detected by echocardiography in Māori patients, which could contribute to poorer outcomes. A retrospective audit was undertaken of patients dispensed with trastuzumab, pertuzumab, and/or doxorubicin chemotherapy agents, and who had serial echocardiography performed at Lakes and Bay of Plenty District Health Boards between January 2018 and January 2021. Baseline demographics, cancer, and cardiovascular disease (CVD) risk information were compared. Cancer therapy-related cardiac dysfunction was classified using current guidelines. Chi-squared and binary regression tests were used to compare incidence rates and outcomes. Māori patients were more likely to smoke (p=0.0002), had previously smoked (p=0.04), and were less likely to be aged >65 years (p=0.003) than non-Māori patients. Cancer therapy-related cardiac dysfunction was observed in 25 of 107 patients (23%). Seventeen of 58 (29%) Māori patients developed CTRCD compared with eight of 49 (16%) non-Māori patients, although this difference was not statistically significant (p=0.11). Smoking was associated with CTRCD (p=0.003). Cancer therapy-related cardiac dysfunction was associated with mortality in univariate analysis (p=0.02) but not in multivariate analysis (0.06). There was a non-significant trend towards more Māori patients developing CTRCD, with larger studies needed to investigate this association. Assessing for association of CTRCD to CVD risk factors was limited by a lack of confirmed absence of risk factors. Cancer therapy-related cardiac dysfunction was associated with mortality in univariate analysis and further prospective research is suggested.