Jacc: Cardiooncology最新文献

{"title":"Incident Myocardial Infarction, Heart Failure, and Oncologic Outcomes in Breast Cancer Survivors","authors":"Oscar Calvillo-Argüelles MD ,&nbsp;Paaladinesh Thavendiranathan MD, SM ,&nbsp;Yue Chen MScPH ,&nbsp;Jiming Fang PhD ,&nbsp;Peter C. Austin PhD ,&nbsp;Eitan Amir MD, PhD ,&nbsp;Douglas S. Lee MD, PhD ,&nbsp;Husam Abdel-Qadir MD, PhD","doi":"10.1016/j.jaccao.2024.08.008","DOIUrl":"10.1016/j.jaccao.2024.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is associated with higher rates of incident cancer. Data are scarce regarding the association of incident CVD with oncologic outcomes after a cancer diagnosis.</div></div><div><h3>Objectives</h3><div>This study sought to determine whether incident myocardial infarction (MI) or heart failure (HF) in breast cancer survivors is associated with oncologic outcomes.</div></div><div><h3>Methods</h3><div>This was a population-based cohort study in Ontario, Canada, using linked administrative data sets of women diagnosed with first breast cancer between April 1, 2007, and March 31, 2015. A landmark analysis was conducted of women alive 2 years after breast cancer diagnosis, aged ≥40 years, and with available staging data and without recurrent/distant disease or preceding CVD. The exposure was a composite of MI and/or HF after the landmark date. The outcomes were cancer mortality, new non-breast malignancy diagnosis, and new chemotherapy initiation. Multivariable cause-specific hazards regression was used to determine the association of incident MI/HF (time-varying exposure) with outcomes.</div></div><div><h3>Results</h3><div>A total of 30,694 women (median age of 60 years) were included, of whom 1,346 developed incident MI/HF at a median of 3.9 years after the landmark date. At 5 years, the cumulative incidence was 5.9% (95% CI: 5.6%-6.1%) for cancer death, 4.3% (95% CI: 4.1%-4.6%) for non-breast malignancy, and 25.7% (95% CI: 25.2%-26.2%) for new chemotherapy. Incident MI/HF was associated with a higher hazard of cancer death (HR: 3.94; 95% CI: 3.38-4.59), non-breast malignancy (HR: 1.39; 95% CI: 1.06-1.82), and new chemotherapy (HR: 1.25; 95% CI: 1.02-1.53).</div></div><div><h3>Conclusions</h3><div>Incident MI and/or HF after breast cancer treatment are associated with higher hazards of adverse oncologic outcomes, highlighting the need to prioritize care for these patients.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 893-903"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease With Hormone Therapy and Ovarian Suppression in Premenopausal Breast Cancer Survivors","authors":"Elizabeth J. Polter PhD ,&nbsp;Anna E. Prizment PhD ,&nbsp;Rob F. Walker MPH ,&nbsp;Zoe Ryan BS ,&nbsp;Wendy Wang PhD ,&nbsp;Anne H. Blaes MD ,&nbsp;Pamela L. Lutsey PhD","doi":"10.1016/j.jaccao.2024.08.006","DOIUrl":"10.1016/j.jaccao.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Hormone therapies, including aromatase inhibitors and tamoxifen, are used with ovarian suppression to improve outcomes in premenopausal patients with breast cancer. Cardiovascular impacts of these treatments among premenopausal women are unknown.</div></div><div><h3>Objectives</h3><div>The aim of this study was to test the hypothesis that the use of aromatase inhibitors in combination with ovarian suppression, relative to tamoxifen, is associated with greater incident cardiovascular disease (CVD) risk in premenopausal breast cancer survivors.</div></div><div><h3>Methods</h3><div>The MarketScan administrative claims databases (2013-2020) were used to identify enrollees younger than 55 years who had incident breast cancer and were treated with either an aromatase inhibitor and ovarian suppression or tamoxifen. Propensity score matching was used to balance treatment groups across confounding variables including age, breast cancer treatments, and comorbidities. The HR for CVD (including atrial fibrillation, myocardial infarction, stroke, heart failure hospitalization, angina, or coronary revascularization) was calculated by treatment group.</div></div><div><h3>Results</h3><div>In the matched cohort, over a median follow-up time of 1.55 years, the incidence rate was 2.3 per 100 person-years among users of aromatase inhibitors plus ovarian suppression (51 CVD events in 2,205 person-years) and 1.0 per 100 person-years for tamoxifen users (102 CVD events in 9,913 person-years). Users of aromatase inhibitors plus ovarian suppression had a 2.20-fold higher hazard of CVD than tamoxifen users (HR: 2.20; 95% CI: 1.57-3.09). In absolute terms, the incidence rate difference was 0.012 (95% CI: 0.006-0.019). Findings were robust to several sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Premenopausal patients with breast cancer treated with aromatase inhibitors and ovarian suppression may be at elevated risk for CVD and should be monitored for cardiovascular risk.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 907-918"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy","authors":"Maarten J. Beekman MD ,&nbsp;Lara Terra MD ,&nbsp;Bernadette A.M. Heemskerk-Gerritsen PhD ,&nbsp;Carlijn M. van der Aalst PhD ,&nbsp;Jeanine E. Roeters van Lennep MD, PhD ,&nbsp;Marc van Beurden MD, PhD ,&nbsp;Helena C. van Doorn MD, PhD ,&nbsp;Joanne A. de Hullu MD, PhD ,&nbsp;Eleonora B.L. van Dorst MD ,&nbsp;Constantijne H. Mom MD, PhD ,&nbsp;Marian J.E. Mourits MD, PhD ,&nbsp;Brigitte F.M. Slangen MD, PhD ,&nbsp;Annemarieke Bartels-Rutten MD, PhD ,&nbsp;Ricardo P.J. Budde MD, PhD ,&nbsp;Miranda M. Snoeren MD ,&nbsp;Tim Leiner MD, PhD ,&nbsp;Pim A. de Jong MD, PhD ,&nbsp;Rozemarijn Vliegenthart MD, PhD ,&nbsp;R. Nils Planken MD, PhD ,&nbsp;Casper Mihl MD, PhD ,&nbsp;Flora E. van Leeuwen PhD","doi":"10.1016/j.jaccao.2024.09.011","DOIUrl":"10.1016/j.jaccao.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at high familial risk of ovarian cancer leads to immediate menopause. Although early natural menopause is associated with increased cardiovascular disease risk, evidence on long-term cardiovascular disease risk after early surgical menopause is scarce.</div></div><div><h3>Objectives</h3><div>We sought to determine the long-term influence of the timing of RRSO on the development of coronary artery calcium (CAC), an established marker for cardiovascular disease risk.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study (N = 733) nested in a nationwide cohort of women at high familial risk of ovarian cancer. In women aged 60-70 years (n = 328), we compared CAC scores between women with a premenopausal RRSO (age ≤45 years) and women with a postmenopausal RRSO (age ≥54 years), using multivariable Poisson analyses. Within the premenopausal RRSO group (n = 498), we also examined the effect of age at RRSO. In addition, we compared the premenopausal RRSO group with an external reference cohort (n = 5,226).</div></div><div><h3>Results</h3><div>Multivariable analyses showed that the prevalence rates of any CAC (CAC &gt;0), at least moderate CAC (CAC &gt;100), and severe CAC (CAC &gt;400) were comparable between the premenopausal and postmenopausal RRSO groups (relative risk [RR]: 0.93; 95% CI: 0.75-1.15 for any CAC; RR: 0.71; 95% CI: 0.43-1.17 for at least moderate CAC; RR: 0.81; 95% CI: 0.30-2.13 for severe CAC). There was no difference in CAC between the premenopausal RRSO group and a similar aged reference cohort. Timing of premenopausal RRSO (early premenopausal RRSO [&lt;41 years] vs late premenopausal RRSO [41-45 years]) did not affect the outcomes.</div></div><div><h3>Conclusions</h3><div>Our results do not show a long-term adverse effect of surgical menopause on the development of CAC.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 922-931"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors","authors":"Florian Moik MD, PhD ,&nbsp;Jakob M. Riedl MD, PhD ,&nbsp;Dominik Barth MD, PhD ,&nbsp;Franziska Berton ,&nbsp;Michael Fink ,&nbsp;Cornelia Englisch MD ,&nbsp;Christoph Hoeller MD ,&nbsp;Thorsten Fuereder MD ,&nbsp;Leyla Ay MD ,&nbsp;Ingrid Pabinger MD ,&nbsp;Erika Richtig MD ,&nbsp;Nikolaus John MD ,&nbsp;Sarah M. Kostmann BSc, MSc, MSc ,&nbsp;Philipp J. Jost MD ,&nbsp;Armin Gerger MD ,&nbsp;Angelika Terbuch MD ,&nbsp;Matthias Preusser MD ,&nbsp;Cihan Ay MD","doi":"10.1016/j.jaccao.2024.09.007","DOIUrl":"10.1016/j.jaccao.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer treated with immune-checkpoint inhibitors (ICIs) have a substantial risk of venous thromboembolism (VTE). The association between ICI-induced inflammation and hypercoagulability is unclear, and no biomarkers currently exist to stratify VTE risk.</div></div><div><h3>Objectives</h3><div>The authors sought to determine the association between the early changes in C-reactive protein (CRP) after ICI initiation and the risk of VTE.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with cancer initiating ICI therapy from 2 academic cancer centers, serving as discovery and external validation cohorts. Patients were stratified based on CRP trajectories during the first 3 months of ICI treatment, with a CRP rise defined as a 2-fold increase from baseline. Patients were followed for VTE for the duration of ICI therapy, and competing risk and time-dependent analyses were used.</div></div><div><h3>Results</h3><div>A total of 822 patients were included. In the discovery cohort (n = 405), the cumulative VTE incidence in patients with a CRP rise (n = 159, 39.3%) was 19.9% (95% CI: 8.4%-34.8%), compared with 8.6% (3.1%-17.6%) in those without a CRP rise. After adjusting for key patient- and cancer-specific confounders, the subdistribution HR for VTE in patients with a CRP rise was 2.64 (95% CI: 1.06-6.62). This was confirmed in the external validation cohort (n = 417; subdistribution HR: 2.25; 95% CI: 1.03-4.94), with VTE incidences of 22.9% (95% CI: 9.7%-39.3%) in patients with a CRP rise and 10.8% (95% CI: 7.4%-15.1%) in those without. The association between CRP rise and VTE risk was confirmed in a time-dependent analysis and was consistent after adjusting for disease progression as a potential time-dependent confounder.</div></div><div><h3>Conclusions</h3><div>Early CRP changes during ICI therapy are associated with an increased risk of VTE, suggesting a potential association between ICI-induced inflammation and hypercoagulability. CRP trajectories may serve as a biomarker for ICI-associated VTE.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 965-975"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal Therapy and Cardiovascular Health","authors":"Farzin Khosrow-Khavar PhD ,&nbsp;Laurent Azoulay PhD","doi":"10.1016/j.jaccao.2024.10.009","DOIUrl":"10.1016/j.jaccao.2024.10.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 919-921"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Atrial Fibrillation After Thoracic Radiotherapy","authors":"Santino Butler MD ,&nbsp;Hyunsoo No MD ,&nbsp;Felicia Guo BA ,&nbsp;Gibran Merchant BS ,&nbsp;Natalie J. Park BA ,&nbsp;Scott Jackson MS ,&nbsp;Daniel Eugene Clark MD ,&nbsp;Lucas Vitzthum MD ,&nbsp;Alex Chin MD, MBA ,&nbsp;Kathleen Horst MD ,&nbsp;Richard T. Hoppe MD ,&nbsp;Billy W. Loo MD, PhD ,&nbsp;Maximilian Diehn MD, PhD ,&nbsp;Michael Sargent Binkley MD, MS","doi":"10.1016/j.jaccao.2024.08.007","DOIUrl":"10.1016/j.jaccao.2024.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) has been associated with thoracic radiotherapy, but the specific risk with irradiating different cardiac substructures remains unknown.</div></div><div><h3>Objectives</h3><div>This study sought to examine the relationship between irradiation of cardiac substructures and the risk of clinically significant (grade ≥3) AF.</div></div><div><h3>Methods</h3><div>We analyzed data from patients who underwent definitive radiotherapy for localized cancers (non–small cell lung, breast, Hodgkin lymphoma, or esophageal) at our institution between 2004 and 2022. The 2-Gy fraction equivalent dose was calculated for cardiac substructures, including the pulmonary veins (PVs), left atrium, sinoatrial node, and left coronary arteries (the left main, left anterior descending, and left circumflex arteries). Competing risk models (subdistribution HRs [sHRs]) for AF incidence were adjusted for the Mayo AF risk score (MAFRS).</div></div><div><h3>Results</h3><div>Among 539 patients, the median follow-up was 58.8 months. The 5-year cumulative incidence of AF was 11.1% for non–small cell lung cancer, 8.3% for esophageal cancer, 1.3% for breast cancer, and 0.8% for Hodgkin lymphoma. Increased AF risk was associated with a higher PV maximum dose (d_max) (sHR: 1.22; <em>P &lt;</em> 0.001), larger left atrial volume (sHR: 1.01; <em>P =</em> 0.002), greater smoking history in pack-years (sHR: 1.01; <em>P =</em> 0.010), and higher MAFRS (sHR: 1.16; <em>P &lt;</em> 0.001). PV d_max remained a significant predictor of AF across different MAFRS subgroups (<em>P</em>_interaction = 0.11), and a PV d_max &gt;39.7 Gy was linked to a higher AF risk, even when stratified by MAFRS.</div></div><div><h3>Conclusions</h3><div>PV d_max is a significant predictor of grade ≥3 AF regardless of underlying risk factors. These findings highlight the importance of cardiac substructures in radiation toxicity and suggest that various PV dose metrics should be further validated in clinical settings.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 935-945"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rise and Fall of C-Reactive Protein","authors":"Tzu-Fei Wang MD, MPH","doi":"10.1016/j.jaccao.2024.10.001","DOIUrl":"10.1016/j.jaccao.2024.10.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 976-978"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(24)00406-X","DOIUrl":"10.1016/S2666-0873(24)00406-X","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages I-CLXXIX"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board/Officers Page","authors":"","doi":"10.1016/S2666-0873(24)00374-0","DOIUrl":"10.1016/S2666-0873(24)00374-0","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages i-iv"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease and Breast Cancer","authors":"Jacqueline B. Vo PhD, RN, MPH ,&nbsp;Véronique L. Roger MD, MPH","doi":"10.1016/j.jaccao.2024.10.008","DOIUrl":"10.1016/j.jaccao.2024.10.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 904-906"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}