Doenças Cardiovasculares e Diagnóstico

Findings from a Population-Based Cohort Study on the Risk of Heart Disease after Breast Cancer Treatment

Abstract

Lia Bittencourt

Introduction: Worries about therapy related cardiotoxicities in bosom malignant growth patients are developing. The aim of this study was to determine the prevalence of ischemic heart disease, heart failure, and arrhythmia in breast cancer patients based on time and treatment.

Methods: In a register-based matched cohort study, Stockholm-Gotland breast cancer patients diagnosed between 2001 and 2008 were compared to matched controls from the general population for their time-dependent risks of arrhythmia, heart failure, and ischemic heart disease using flexible parametric models. Breast cancer patients' treatment-specific effects were estimated using the Cox model.

Results: Time-dependent analyses revealed a longer-term increased risk of heart failure and arrhythmia following a breast cancer diagnosis. Arrhythmia had risk ratios (HRs) of 2.14 (95% CI=1.63-2.81) and cardiovascular breakdown had risk ratios (HRs) of 2.71 (95% CI=1.70-4.33) in the primary year of conclusion. After ten years, the HR was 1.42 (95% CI=1.21–1.67) for arrhythmia and 1.28 (95% CI=1.03–1.59) for heart failure. The risk of ischemic heart disease only significantly increased in the first year after diagnosis (HR=1.45, 95 percent confidence interval (CI)=1.03–2.04)). There was a link between Trastuzumab and anthracyclines and an increased risk of cardiovascular breakdown. Aromatase inhibitors, but not tamoxifen, were linked to the risk of ischemic heart disease. There was no evidence that locoregional radiotherapy increased the risk of heart disease.

Conclusion: Heart disease appears to be linked to systemic adjuvant therapies. The risk estimates found in this study may assist decision-making regarding adjuvant therapy and patient counseling in oncology settings.