Utilization of a cardio-oncology clinic: A single center experience.

Abstract

e19192 Background: Many systemic anti-cancer therapies (chemotherapy, immunotherapy and radiation) have known cardiac toxicities. The field of cardio-oncology aims to optimize the cardiac health of cancer patients. Our goal was to evaluate baseline clinical characteristics, referral patterns and the rate of adverse cardiac outcomes in patients referred to a single cardio-oncology clinic at a tertiary care academic center. Methods: We performed a retrospective review of 100 consecutive patients who established care at a cardio-oncology clinic between 2011-2019. Baseline clinical data was collected from the initial presentation. Interventions and subsequent adverse cardiac events that occurred within a 6-24 month follow-up period were recorded. Fisher’s exact test was used to compare the measured variables. Results: Of the 100 patients, the median age was 63 years old and 69% were women. The most common reasons for referral were echocardiographic changes in systolic function or symptomatic congestive heart failure (HF) (54%; 54/100). Of patients who received anti-cancer therapy, only 18% (17/95) were referred for a pre-treatment cardiac evaluation. The rate of new HF diagnoses or worsening HF symptoms, defined by decreased NYHA class or HF-related hospitalizations, was 6% in the cancer treatment naïve group and 12% in the group that was not (p=0.68). Anti-cancer therapy was stopped or changed in 6 patients who were diagnosed with HF at any point. Conclusions: Our study provides insight into referral practices, interventions and outcomes at a single cardio-oncology clinic at a tertiary care academic center. Patients were often referred after the initiation of anti-cancer therapy, with the majority already experiencing a decline in systolic function. There was a higher rate of new HF events in patients who had already been treated with anti-cancer therapy before their first cardio-oncology visit. This may suggest the need for a change in referral practices to optimize cardiac health, specifically a shift in cardio-oncology evaluation prior to initiation of anti-cancer therapy. [Table: see text]