Factors impacting on the early versus late major adverse cardiovascular events amongst oncology patients receiving non-anthracycline chemotherapy

Abstract

BACKGROUND: Cardiovascular (CV) events following commencement of cancer treatment are becoming increasingly recognised. The extent to which baseline CV factors influence the onset of major adverse cardiovascular events (MACE) in patients treated with non-anthracycline chemotherapy is not well characterised. The aim of our study was to examine the association between baseline cardiovascular risk factors and early and late complications of non-anthracycline chemotherapy. METHODS: This was a single-centre retrospective analysis of a cohort of oncology patients receiving non-anthracycline chemotherapy at our institution between 2014-2018. Complications of chemotherapy (MACE) were defined as pericardial effusion, myocarditis, acute myocardial infarction, arrhythmia, heart failure and CV related death. Associations with patient demographics, individual baseline CV profile, and MACE (early <12 months; late >=12 months) were made. RESULTS: Of 666 patients (58.2% male; mean age 63.3+/-13.6 years), 82 MACE occurred; 2 (0.3%) pericardial effusions, 18 (2.7%) heart failure, 19 (2.9%) myocardial infarction, 30 (4.5%) arrhythmia, 9 (1.4%) stroke and 3 (0.5%) CV-related deaths. There were 36 early events (median time to event 116 (55-230) days) and 46 late events (median time to event 909 (578-1,665.3) days). No significant difference in baseline CV risk factors was found between MACE and non-MACE groups, and early-MACE and late-MACE groups. No significant difference in type of MACE was found between early-MACE and late-MACE groups. CONCLUSIONS: Traditional CV risk factors appear to play a less well-defined role in the timing of MACE following use of cancer treatment. Exploration of the mechanism behind the onset of MACE in this population is warranted.