TY - JOUR
T1 - Racial and Ethnic Differences in Cardiac Surveillance Evaluation of Patients Treated With Anthracycline-Based Chemotherapy
AU - Deremer, David L.
AU - Nguyen, Nam K.
AU - Guha, Avirup
AU - Ahmad, Faraz S.
AU - Cooper-Dehoff, Rhonda M.
AU - Pepine, Carl J.
AU - Fradley, Michael G.
AU - Gong, Yan
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2023/5/16
Y1 - 2023/5/16
N2 - BACKGROUND: Anthracyclines remain a key treatment for many malignancies but can increase the risk of heart failure or cardiomyopathy. Specific guidelines recommend echocardiography and serum cardiac biomarkers such as BNP (B-type natriuretic peptide) or NT-proBNP (N-terminal proBNP) evaluation before and 6 to 12 months after treatment. Our objective was to evaluate associations between racial and ethnic groups in cardiac surveillance of survivors of cancer after exposure to anthracyclines. METHODS AND RESULTS: Adult patients in the OneFlorida Consortium without prior cardiovascular disease who received at least 2 cycles of anthracyclines were included in the analysis. Multivariable logistic regression was performed to estimate the odds ratios (ORs) and 95% CIs for receiving cardiac surveillance at baseline before anthracycline therapy, 6 months after, and 12 months after anthracycline exposure among different racial and ethnic groups. Among the entire cohort of 5430 pa-tients, 63.4% had a baseline echocardiogram, with 22.3% receiving an echocardiogram at 6 months and 25% at 12 months. Non-Hispanic Black (NHB) patients had a lower likelihood of receiving a baseline echocardiogram than Non-Hispanic White (NHW) patients (OR, 0.75 [95% CI, 0.63–0.88]; P=0.0006) or any baseline cardiac surveillance (OR, 0.76 [95% CI, 0.64–0.89]; P=0.001). Compared with NHW patients, Hispanic patients received significantly less cardiac surveillance at the 6-month (OR, 0.84 [95% CI, 0.72–0.98]; P=0.03) and 12-month (OR, 0.85 [95% CI, 0.74–0.98]; P=0.03) time points, respectively. CONCLUSIONS: There were significant racial and ethnic differences in cardiac surveillance among survivors of cancer at baseline and following anthracycline-based treatment in NHB and Hispanic cohorts. Health care providers need to be cognizant of these social inequities and initiate efforts to ensure recommended cardiac surveillance occurs following anthracyclines.
AB - BACKGROUND: Anthracyclines remain a key treatment for many malignancies but can increase the risk of heart failure or cardiomyopathy. Specific guidelines recommend echocardiography and serum cardiac biomarkers such as BNP (B-type natriuretic peptide) or NT-proBNP (N-terminal proBNP) evaluation before and 6 to 12 months after treatment. Our objective was to evaluate associations between racial and ethnic groups in cardiac surveillance of survivors of cancer after exposure to anthracyclines. METHODS AND RESULTS: Adult patients in the OneFlorida Consortium without prior cardiovascular disease who received at least 2 cycles of anthracyclines were included in the analysis. Multivariable logistic regression was performed to estimate the odds ratios (ORs) and 95% CIs for receiving cardiac surveillance at baseline before anthracycline therapy, 6 months after, and 12 months after anthracycline exposure among different racial and ethnic groups. Among the entire cohort of 5430 pa-tients, 63.4% had a baseline echocardiogram, with 22.3% receiving an echocardiogram at 6 months and 25% at 12 months. Non-Hispanic Black (NHB) patients had a lower likelihood of receiving a baseline echocardiogram than Non-Hispanic White (NHW) patients (OR, 0.75 [95% CI, 0.63–0.88]; P=0.0006) or any baseline cardiac surveillance (OR, 0.76 [95% CI, 0.64–0.89]; P=0.001). Compared with NHW patients, Hispanic patients received significantly less cardiac surveillance at the 6-month (OR, 0.84 [95% CI, 0.72–0.98]; P=0.03) and 12-month (OR, 0.85 [95% CI, 0.74–0.98]; P=0.03) time points, respectively. CONCLUSIONS: There were significant racial and ethnic differences in cardiac surveillance among survivors of cancer at baseline and following anthracycline-based treatment in NHB and Hispanic cohorts. Health care providers need to be cognizant of these social inequities and initiate efforts to ensure recommended cardiac surveillance occurs following anthracyclines.
KW - anthracyclines
KW - health disparities
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85159739388&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159739388&partnerID=8YFLogxK
U2 - 10.1161/JAHA.122.027981
DO - 10.1161/JAHA.122.027981
M3 - Article
C2 - 37158063
AN - SCOPUS:85159739388
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 10
M1 - e027981
ER -
