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Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab
BACKGROUND: There is limited evidence regarding the impact of cardiology involvement in the care of cancer patients. OBJECTIVES: This study evaluated the impact of cardiology involvement on guideline-adherent cardiovascular monitoring and risk factor management in patients with breast cancer treated...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701353/ https://www.ncbi.nlm.nih.gov/pubmed/33263112 http://dx.doi.org/10.1016/j.jaccao.2020.04.010 |
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author | Demissei, Biniyam G. Adusumalli, Srinath Hubbard, Rebecca A. Denduluri, Srinivas Narayan, Vivek Clark, Amy S. Shah, Payal Knollman, Hayley Getz, Kelly D. Aplenc, Richard Carver, Joseph R. Ky, Bonnie |
author_facet | Demissei, Biniyam G. Adusumalli, Srinath Hubbard, Rebecca A. Denduluri, Srinivas Narayan, Vivek Clark, Amy S. Shah, Payal Knollman, Hayley Getz, Kelly D. Aplenc, Richard Carver, Joseph R. Ky, Bonnie |
author_sort | Demissei, Biniyam G. |
collection | PubMed |
description | BACKGROUND: There is limited evidence regarding the impact of cardiology involvement in the care of cancer patients. OBJECTIVES: This study evaluated the impact of cardiology involvement on guideline-adherent cardiovascular monitoring and risk factor management in patients with breast cancer treated with trastuzumab. METHODS: In a single-center retrospective cohort study, electronic health records from 1,047 patients with breast cancer receiving trastuzumab between January 2009 and July 2018 were evaluated. A visit to a cardiology provider beginning from the 3 months before cancer therapy initiation until the last contact date defined cardiology involvement. Guideline-adherent monitoring, defined by echocardiography assessment within the 4 months before trastuzumab initiation and follow-up echocardiography at least every 4 months during therapy, was compared in patients with and without cardiology involvement before treatment initiation. Multivariable associations between cardiology involvement and the time-varying risk factors blood pressure and body mass index (BMI) were assessed by using generalized estimating equations. RESULTS: Cardiology involvement occurred in 293 (28%) patients. A higher proportion of patients with cardiology involvement before trastuzumab initiation had guideline-adherent monitoring (76.4% vs. 60.1%; p = 0.007). Cardiology involvement was associated with an average 1.5 mm Hg (95% CI: –2.9 to –0.1; p = 0.035) lower systolic blood pressure, which was more pronounced in those with hypertension (–2.7 mm Hg; 95% CI: –4.6 to –0.7; p = 0.007). Cardiology involvement was associated with a lower BMI in patients with baseline BMI ≥25 kg/m(2) (mean difference: –0.5 kg/m(2); 95% CI: –1.0 to –0.1; p = 0.027). CONCLUSIONS: Cardiology involvement in patients with breast cancer treated with trastuzumab is associated with greater adherence to cardiovascular monitoring and modest improvements in risk factor control. |
format | Online Article Text |
id | pubmed-7701353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-77013532020-11-30 Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab Demissei, Biniyam G. Adusumalli, Srinath Hubbard, Rebecca A. Denduluri, Srinivas Narayan, Vivek Clark, Amy S. Shah, Payal Knollman, Hayley Getz, Kelly D. Aplenc, Richard Carver, Joseph R. Ky, Bonnie JACC CardioOncol Original Research BACKGROUND: There is limited evidence regarding the impact of cardiology involvement in the care of cancer patients. OBJECTIVES: This study evaluated the impact of cardiology involvement on guideline-adherent cardiovascular monitoring and risk factor management in patients with breast cancer treated with trastuzumab. METHODS: In a single-center retrospective cohort study, electronic health records from 1,047 patients with breast cancer receiving trastuzumab between January 2009 and July 2018 were evaluated. A visit to a cardiology provider beginning from the 3 months before cancer therapy initiation until the last contact date defined cardiology involvement. Guideline-adherent monitoring, defined by echocardiography assessment within the 4 months before trastuzumab initiation and follow-up echocardiography at least every 4 months during therapy, was compared in patients with and without cardiology involvement before treatment initiation. Multivariable associations between cardiology involvement and the time-varying risk factors blood pressure and body mass index (BMI) were assessed by using generalized estimating equations. RESULTS: Cardiology involvement occurred in 293 (28%) patients. A higher proportion of patients with cardiology involvement before trastuzumab initiation had guideline-adherent monitoring (76.4% vs. 60.1%; p = 0.007). Cardiology involvement was associated with an average 1.5 mm Hg (95% CI: –2.9 to –0.1; p = 0.035) lower systolic blood pressure, which was more pronounced in those with hypertension (–2.7 mm Hg; 95% CI: –4.6 to –0.7; p = 0.007). Cardiology involvement was associated with a lower BMI in patients with baseline BMI ≥25 kg/m(2) (mean difference: –0.5 kg/m(2); 95% CI: –1.0 to –0.1; p = 0.027). CONCLUSIONS: Cardiology involvement in patients with breast cancer treated with trastuzumab is associated with greater adherence to cardiovascular monitoring and modest improvements in risk factor control. Elsevier 2020-06-16 /pmc/articles/PMC7701353/ /pubmed/33263112 http://dx.doi.org/10.1016/j.jaccao.2020.04.010 Text en © 2020 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Demissei, Biniyam G. Adusumalli, Srinath Hubbard, Rebecca A. Denduluri, Srinivas Narayan, Vivek Clark, Amy S. Shah, Payal Knollman, Hayley Getz, Kelly D. Aplenc, Richard Carver, Joseph R. Ky, Bonnie Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title | Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title_full | Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title_fullStr | Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title_full_unstemmed | Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title_short | Cardiology Involvement in Patients With Breast Cancer Treated With Trastuzumab |
title_sort | cardiology involvement in patients with breast cancer treated with trastuzumab |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701353/ https://www.ncbi.nlm.nih.gov/pubmed/33263112 http://dx.doi.org/10.1016/j.jaccao.2020.04.010 |
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