Temporal Trends of Cardiac Outcomes and Impact on Survival in Patients With Cancer
Section snippets
Methods
All adult patients with cancer referred to the cardio-oncology service at the Cleveland Clinic from January 2011 to June 2018 were included. The study protocol was reviewed and approved by the Cleveland Clinic Institutional Review Board with waiver of patient informed consent. Patients or public were not directly involved in the design, conduct, reporting, or dissemination plans of our research.
The patient pool in this study represents oncology patients seen by oncology specialists at our
Results
Total 6,754 oncology patients referred to the cardio-oncology service at the Cleveland Clinic from January 2011 to June 2018 were analyzed. Table 1 details baseline patient characteristics for the total cohort relative to start of chemotherapy (time zero). Despite a relatively young cohort (median age was 57 (SD, 47 to 65 years), 5,144 patients (76%) had 1 or more of these risk factors at baseline; 2,767 patients (41%) had 2 or more, whereas 908 patients (13%) had preexisting CVD. Breast
Discussion
First diagnosis of CVD events in patients referred to cardio-oncology peaked around the time of chemotherapy. In Figure 1, it appears that vast majority of events occurred at time zero - that is, at start of chemotherapy, but when time on the x-axis is spread out over months (Supplemental Figure 1), it can be seen that this increased event rate is normally distributed. The number of echocardiograms performed also dramatically peaked around this time which would account for some new diagnoses (
Declarations
Conflicts of interest/ Competing interests: None
Ethics approval: Reviewed and approved by the Institutional Review Board with waiver of individual informed consent
Consent to participate: Yes
Consent for publication: Yes
Availability of data and material: Upon request
Code availability: Upon request
Authors contribution
1. Conception or design of the work- MH, YH, BH, SN, BG, FC, PC.
2. Data collection- MH, YH, BH, FC, PC.
3. Data analysis and interpretation- MH, YH, BH, FC, PC.
4. Drafting the article- MH, YH, BH, FC, PC.
5. Critical revision of the article- MH, YH, CW, RM, CS, JA, TB, WT, EF, KJ, JE, BX, BH, PCr, CJ, RG, NG, ZP, LC, MD, SN, SK, LS, BG, FC, PC.
6. Final approval of the version to be published- MH, YH, CW, RM, CS, JA, TB, WT, EF, KJ, JE, BX, BH, PCr, CJ, RG, NG, ZP, LC, MD, SN, SK, LS, BG, FC, PC.
Declaration of interests
The authors declare that they have no known competing financial interests or personal relations that could have appeared to influence the work reported in this study.
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This work was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under Award Number K99 HL138272 and R00 HL138272 to F.C.
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These authors are joint first authors on this work.