Cardio-oncologyPub Date : 2025-07-02DOI: 10.1186/s40959-025-00351-4
Christopher W Hoeger, Arrush Choudhary, Andrea Nathalie Rosas Diaz, Theresa Pinto, Sarah Smalec, Charles Doladille, Rishi Wadhera, Meghan Shea, Sumanth Khadke, Joe-Elie Salem, Sarju Ganatra, Aarti Asnani
{"title":"Cardiotoxicity of combined pegylated liposomal doxorubicin and bevacizumab therapy: a propensity-matched cohort study and disproportionality analysis.","authors":"Christopher W Hoeger, Arrush Choudhary, Andrea Nathalie Rosas Diaz, Theresa Pinto, Sarah Smalec, Charles Doladille, Rishi Wadhera, Meghan Shea, Sumanth Khadke, Joe-Elie Salem, Sarju Ganatra, Aarti Asnani","doi":"10.1186/s40959-025-00351-4","DOIUrl":"10.1186/s40959-025-00351-4","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"59"},"PeriodicalIF":3.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-26DOI: 10.1186/s40959-025-00359-w
Anton Burkhard-Meier, Dorit Di Gioia, Vindi Jurinovic, Michael Hoberger, Sinan E Güler, Michael Völkl, Stefanie Corradini, Aurélie V Gaasch, Annabel H S Alig, Thomas Knösel, Christian Hagl, Christian Schneider, Wulf Sienel, Wolfgang G Kunz, Caspar Burkhard-Meier, Michael von Bergwelt-Baildon, Lars H Lindner, Luc M Berclaz
{"title":"Primary cardiac sarcoma: insights from two decades of multimodal management at LMU Munich.","authors":"Anton Burkhard-Meier, Dorit Di Gioia, Vindi Jurinovic, Michael Hoberger, Sinan E Güler, Michael Völkl, Stefanie Corradini, Aurélie V Gaasch, Annabel H S Alig, Thomas Knösel, Christian Hagl, Christian Schneider, Wulf Sienel, Wolfgang G Kunz, Caspar Burkhard-Meier, Michael von Bergwelt-Baildon, Lars H Lindner, Luc M Berclaz","doi":"10.1186/s40959-025-00359-w","DOIUrl":"10.1186/s40959-025-00359-w","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"58"},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-20DOI: 10.1186/s40959-025-00357-y
Tagayasu Anzai, Kenji Hirata, Ken Kato, Kohsuke Kudo
{"title":"Correction: Machine learning for cardio-oncology: predicting global longitudinal strain from conventional echocardiographic measurements in cancer patients.","authors":"Tagayasu Anzai, Kenji Hirata, Ken Kato, Kohsuke Kudo","doi":"10.1186/s40959-025-00357-y","DOIUrl":"10.1186/s40959-025-00357-y","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"57"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-20DOI: 10.1186/s40959-025-00356-z
Helena Carreira, Helen Strongman, Maria Feychting, Laila Hubbert, Elham Hedayati, Patrick Bidulka, Anthony Matthews, Krishnan Bhaskaran
{"title":"Use of anthracyclines and trastuzumab for breast cancer in women with and without a history of cardiovascular disease in Sweden: a national cross-sectional study.","authors":"Helena Carreira, Helen Strongman, Maria Feychting, Laila Hubbert, Elham Hedayati, Patrick Bidulka, Anthony Matthews, Krishnan Bhaskaran","doi":"10.1186/s40959-025-00356-z","DOIUrl":"10.1186/s40959-025-00356-z","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular toxicity concerns have limited the use of anthracyclines and trastuzumab among breast cancer patients with cardiovascular disease (CVD) but evidence on real-world prescribing patterns is scarce. We aimed to describe the use of these drugs in women with and without CVD when diagnosed with non-metastatic breast cancer in Sweden.</p><p><strong>Methods: </strong>Using Swedish national registers (2010-15), we identified breast cancer treatment and prior CVD from hospital and prescription data. We calculated prevalence of anthracycline and trastuzumab use in women with and without prior CVD, and estimated prevalence ratios (PR) comparing these groups, adjusted for age, stage, and other patient and tumour-related factors.</p><p><strong>Results: </strong>Among 32,590 women with breast cancer, 10,702 (33%) had prior CVD. Anthracycline use was lower in those with vs without prior CVD (2,169/10,702 [20.3%] vs 8,654/21,888 [39.5%], crude PR 0.51, 0.49-0.53); the PR attenuated after adjustment for age and other factors (adj-PR 0.90, 0.87-0.93). There was substantial variation by type of CVD: patients with heart failure were much less likely to receive anthracyclines (adj-PR 0.46, 0.35-0.57) while prior venous thromboembolism (VTE) had no impact (adj-PR 0.98, 0.88-1.09). Among HER2 + patients, trastuzumab use showed similar patterns, with prevalence of 630/1,100 [57.3%] vs 2,279/2,866 [79.5%] for any vs no prior CVD (crude PR = 0.72, 0.68-0.76, adjusted PR = 0.95, 0.90-0.99); adjusted PRs for specific outcomes ranged from 0.77 (0.61-0.93) for heart failure, to 1.04 (0.92-1.15) for VTE.</p><p><strong>Conclusion: </strong>While prior CVD was associated with lower use of potentially cardiotoxic breast cancer therapies, substantial numbers of patients with CVD still received these treatments, with marked variation by type of CVD. These real-world data suggest variable cardiovascular toxicity risk stratification before anticancer therapy and highlight the need for evidence-based guidance on negotiating the risk-benefit balance in these patients.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"56"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Importance of E/e' and BNP for early detection of late cardiotoxicity in long-term follow-up of childhood hematologic cancer survivors: a retrospective cross-sectional study.","authors":"Yuri Okazoe-Hirakawa, Kimikazu Yakushijin, Keiji Kurata, Sakuya Matsumoto, Hiroya Ichikawa, Rina Sakai, Taku Nose, Shiro Kimbara, Yoshiaki Nagatani, Taiji Koyama, Yumiko Inui, Yohei Funakoshi, Naomi Kiyota, Mitsuhiro Ito, Keiko Hatazawa, Hidekazu Tanaka, Nobuyuki Yamamoto, Hironobu Minami","doi":"10.1186/s40959-025-00354-1","DOIUrl":"10.1186/s40959-025-00354-1","url":null,"abstract":"<p><strong>Background: </strong>Childhood cancer survivors (CCS) often develop late complications after their primary disease is cured. Cardiovascular disease is one of the most frequent and serious complications that significantly affects prognosis and quality of life. Early detection and appropriate intervention are expected to improve their prognosis. However, the risk factors for late cardiotoxicity in CCS are not well defined, and biomarkers that can detect cardiac dysfunction prior to the development of heart failure have not yet been established.</p><p><strong>Methods: </strong>Medical records of childhood hematologic cancer survivors referred to our department for transitional care between January 2016 and October 2023 were reviewed for this cross-sectional study. The relationships between the most recent cardiac function at the review and history of cancer treatment were analyzed.</p><p><strong>Results: </strong>This study included 34 patients and the median elapsed time since cancer diagnosis was 16.5 years (range, 5-30 years). None of the patients had symptomatic cardiac complications. The E/e' ratio was significantly higher in survivors with a history of hematopoietic stem cell transplantation (HSCT) than in those who did not undergo HSCT (median, 8.4% vs. 6.25%, P = 0.040), while no intergroup differences were observed in ejection fraction (EF), global longitudinal strain (GLS), or the brain natriuretic protein (BNP) level. In addition, the E/e' ratio was positively correlated with years elapsed since cancer diagnosis (ρ = 0.38, P = 0.034). While there was no clear correlation between years since cancer diagnosis and the BNP level in the overall cohort, a strong correlation was found in patients with a history of HSCT (ρ = 0.73; P < 0.01). No significant differences were observed in EF, E/e' ratio, GLS, and BNP level by cumulative anthracycline dose or history of chest irradiation.</p><p><strong>Conclusions: </strong>In this study, no patient had late symptomatic cardiac complications. However, in those who had survived for a long time since their cancer diagnosis, particularly those with a history of HSCT, there were significant elevations in the E/e' ratio and the BNP level. Continuous follow-up is required to determine whether these abnormalities lead to symptomatic cardiotoxicity and whether they serve as useful markers for the early detection of cardiac complications.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"55"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-13DOI: 10.1186/s40959-025-00350-5
Juan Manuel Garzon-Dangond, Maria F Gomez Ardila, Eduardo Tellez Garcia, Andres E Daryanani, Prema P Peethambaram, Lori A Thicke, Daniela L Stan, Hector R Villarraga
{"title":"Assessing double product derived from stress echocardiography as a prognostic indicator of major adverse cardiac events in patients with breast cancer treated with radiotherapy.","authors":"Juan Manuel Garzon-Dangond, Maria F Gomez Ardila, Eduardo Tellez Garcia, Andres E Daryanani, Prema P Peethambaram, Lori A Thicke, Daniela L Stan, Hector R Villarraga","doi":"10.1186/s40959-025-00350-5","DOIUrl":"https://doi.org/10.1186/s40959-025-00350-5","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors treated with radiotherapy (RT) face elevated long-term risk of cardiovascular complications. Double product (DP), the product of systolic blood pressure and heart rate, reflects myocardial workload and may serve as a simple prognostic marker. We evaluated whether peak DP during exercise or dobutamine stress echocardiography predicts major adverse cardiovascular events (MACE) and all-cause mortality (ACM).</p><p><strong>Methods: </strong>We retrospectively studied patients who had breast cancer treated with RT and underwent follow-up testing with ESE or DSE from 2000 through 2022. Univariate and multivariate Cox regression models were used to evaluate the association between MACE/ACM and risk factors in each group. Kaplan-Meier analysis was used to compare ACM and MACE-free survival among the different DP quartiles.</p><p><strong>Results: </strong>Our study included 696 patients. ESE (n = 425) or DSE (n = 271) was performed at a median of 4.4 (IQR, 2.2-7.5) years after RT. For the ESE group, the rate of MACE was higher in the lowest quartile. Patients in the 3rd and 4th quartile had a decreased risk of MACE and ACM (hazard ratio [HR] per 1,000-mm Hg/min increase, 0.92 [95% CI, 0.88-0.97]; P < .001 and HR, 0.91 [95% CI, 0.87-0.96]; P < .001) respectively. Advanced age (> 60 years) was also seen to be a predictor of MACE in this group (HR, 5.22 [95% CI, 2.13-12.75]; P = < .001). Additionally, treatment with doxorubicin-based chemotherapy was associated with an increased risk of ACM but not MACE (HR, 1.78 [95% CI, 1.04-3.05]; P = .03). For the DSE group, rate of MACE was similar among DP quartiles, indicating that this is not a prognostic indicator. However, a history of diabetes and dyslipidemia were shown to be predictors of MACE (HR, 1.58 [95% CI, 1.05-2.37]; P = .02; and HR, 1.77 [95% CI, 1.12-2.79]; P = .01).</p><p><strong>Conclusions: </strong>DP achieved during ESE but not DSE is an excellent tool for the prediction of MACE and ACM in this patient population; therefore, ESE should be recommended as the test of choice when possible. A history of atrial fibrillation, diabetes and dyslipidemia were identified as significant predictors of adverse cardiovascular outcomes in the DSE group, highlighting individualized monitoring and early intervention for patients at higher risk.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"54"},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-03DOI: 10.1186/s40959-025-00349-y
Buyan-Ochir Orgil, Akhilesh K Bajpai, Neely Alberson, Morgan Lander, Batsaikhan Enkhzul, Hugo R Martinez, Jeffrey A Towbin, Lu Lu, Enkhsaikhan Purevjav
{"title":"Unraveling the genetic blueprint of doxorubicin-induced cardiotoxicity through systems genetics approaches.","authors":"Buyan-Ochir Orgil, Akhilesh K Bajpai, Neely Alberson, Morgan Lander, Batsaikhan Enkhzul, Hugo R Martinez, Jeffrey A Towbin, Lu Lu, Enkhsaikhan Purevjav","doi":"10.1186/s40959-025-00349-y","DOIUrl":"10.1186/s40959-025-00349-y","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline-induced cardiotoxicity (ACT) is a significant concern for cancer survivors, while genetic basis of ACT remains unclear. This study employs a murine genetic reference population (GRP) of BXD recombinant inbred strains, derived from DBA/2J (D2) and C57BL/6J (B6) crosses, to map quantitative trait loci (QTLs) linked to doxorubicin (DOX)-induced phenotypes through systems genetics approaches.</p><p><strong>Methods: </strong>To model variability in ACT, 58 BXD strains and parental B6 and D2 mice (n ≥ 4 mice/sex/strain, 3-4-month-old) underwent an intraperitoneal injection of DOX (20 mg/kg). Survival and body weight (BW) were monitored for 10 days. Echocardiography was performed before treatment and on Day 5 post-treatment, followed by genetic mapping and Mendelian randomization analyses for identifying QTLs and candidate genes associated with DOX-induced traits and severity.</p><p><strong>Results: </strong>Parental B6 strain had 60% survival, whereas 24% of D2 mice survived on Day 10. Among BXD strains, median survival varied, with BXD77 showing the lowest at Day 4. Echocardiography revealed cardiac dysfunction and a small-heart phenotype resembling ACT patients. Significant QTLs on Chromosome 10 (86-94 Mb), Chromosome 19 (52.5-54.2 Mb) and on Chromosome 14 (103-120 Mb) were associated with the survival, mean BW loss, and left ventricular (LV) volumes and ejection fraction (EF%), respectively. MR analysis identified significant causal associations between the genes implicated in BW loss (ADD3, HSPA12 A, SLC18 A2, PDZD8, DUSP5, CASP7) as well as EF% and LV volumes (GPC6, UGGT2, SLAIN1, POU4 F1, MBNL2) in BXD mice post-DOX and heart failure outcomes in humans. Most of the top candidates showed cardiomyocyte specific expression based on scRNA-seq data.</p><p><strong>Conclusions: </strong>Survival, BW loss, and echocardiography parameters considerably varied among DOX-treated BXDs, suggesting significant influence of genetic background on expression of those traits. Several candidate genes that may modulate ACT susceptibility and heart failure were identified, providing a foundation for genetic-based risk stratification and therapeutics in cardio-oncology.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"53"},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-06-02DOI: 10.1186/s40959-025-00353-2
Ramez M Odat, Sakhr Alshwayyat, Dang Nguyen, Tala Abdulsalam Alshwayyat, Hanan M Qasem, Hritvik Jain, Hamdah Hanifa, Osama Aloudat, John C Lin, Wilfred Ngwa, Margaret E G Thompson, Amer Harky
{"title":"Atherosclerosis as a cause of death in patients with cancer: a cohort study.","authors":"Ramez M Odat, Sakhr Alshwayyat, Dang Nguyen, Tala Abdulsalam Alshwayyat, Hanan M Qasem, Hritvik Jain, Hamdah Hanifa, Osama Aloudat, John C Lin, Wilfred Ngwa, Margaret E G Thompson, Amer Harky","doi":"10.1186/s40959-025-00353-2","DOIUrl":"10.1186/s40959-025-00353-2","url":null,"abstract":"<p><strong>Introduction: </strong>Non-cancer deaths are now becoming a significant threat to the health of cancer patients. Death from atherosclerosis is linked to cancer due to the side effects of treatment and its pathogenesis. However, guidelines for identifying cancer patients at the highest risk of death from atherosclerosis remain unclear. In this study, we aimed to identify the correlation between various outcomes and the risk of death from atherosclerosis as well as to determine which cancer subtypes are linked to a higher risk of mortality from atherosclerosis.</p><p><strong>Methods: </strong>Data of all patients diagnosed with cancer between 2000 and 2021 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Data regarding the causes of death and clinicopathological features such as sex, age, race, marital status, SEER stage, and treatment procedures were extracted. We calculated standardized mortality ratios (SMRs) using the SEER*Stat software V8.4.3.</p><p><strong>Results: </strong>Of the 6,891,191 cancer patients, 3,900 (0.057%) died of atherosclerosis, a rate higher than that in the general population (SMR = 1.18, 95% CI [1.15-1.22]). Atherosclerosis-related deaths decreased over time from 1,882 deaths between 2000 and 2004 to 279 deaths between 2015 and 2019. Among the 3,900 atherosclerotic deaths, the highest numbers were observed in patients with digestive cancers (n = 768, 19.7%), particularly colon and rectal cancer (n = 544, 13.9%), prostate cancer (n = 742, 19%), and breast cancer (n = 544, 13.9%). Patients with brain cancer (SMR = 4.96, 95% CI [3.07-7.59]), liver and intrahepatic bile duct cancers (SMR = 3.20, 95% CI [2.24-4.43]), and pancreatic cancer (SMR = 2.69, 95% CI [1.97-3.59]) had a significantly higher rate of death from atherosclerosis than the general population.</p><p><strong>Conclusion: </strong>Our study revealed a higher atherosclerosis mortality risk among patients with cancer in the United States, emphasizing the need for integrated care that addresses cancer and cardiovascular risks to improve overall patient outcomes. However, our conclusions are restricted to the aggregated data provided by SEER, and we encourage future studies to explore more detailed datasets.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"52"},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-05-31DOI: 10.1186/s40959-025-00352-3
Patrick A Kwaah, Samuel A Mensah, Emmanuel A Agyemang, Joseph S Kekrebesi, Daniil Katkov, Abraham Carboo, Grace Appah, Hamza A Rashid, Jennifer M Kwan
{"title":"Atrial fibrillation in breast cancer therapy: does tamoxifen confer a lower risk than aromatase inhibitors?","authors":"Patrick A Kwaah, Samuel A Mensah, Emmanuel A Agyemang, Joseph S Kekrebesi, Daniil Katkov, Abraham Carboo, Grace Appah, Hamza A Rashid, Jennifer M Kwan","doi":"10.1186/s40959-025-00352-3","DOIUrl":"10.1186/s40959-025-00352-3","url":null,"abstract":"<p><strong>Introduction: </strong>Aromatase inhibitors (AIs) have been linked to increased atrial fibrillation(AF) risk due to estrogen depletion however tamoxifen's effect on AF remains conflicting. This study investigates the risk of AF associated with AI use compared to tamoxifen in breast cancer patients.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using the TriNetX database from 2015 to 2024. Breast cancer patients were categorized into two groups: AI users (anastrozole, exemestane, or letrozole) and tamoxifen users. A propensity score matching (1:1) adjusted for demographics, comorbidities, concurrent therapies, and lab values. The incidence of AF was assessed at 1, 5, and 10-years post-treatment initiation.</p><p><strong>Results: </strong>The study included 220,552 AI users and 73,388 tamoxifen users before matching, with 54,175 patients in each group after matching. At 1 year, AI users had a higher risk of AF (0.5% vs. 0.4%, RR: 1.36, p = 0.001). At 5 years, AF incidence remained higher in the AI group (1.2% vs. 1.1%, RR: 1.13, p = 0.035).However at 10 years, the difference in AF risk between the two groups was no longer significant (1.6% vs. 1.5%, RR: 1.05, p = 0.295).</p><p><strong>Conclusion: </strong>AI use is associated with a higher risk of AF than tamoxifen in the first 5 years of treatment, but the risk equalizes at 10 years. Long-term hormonal therapy has an increased risk of AF, highlighting the need for ongoing monitoring and management of risk factors.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"51"},"PeriodicalIF":3.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardio-oncologyPub Date : 2025-05-27DOI: 10.1186/s40959-025-00343-4
Tara Reshadmanesh, Reza Mohebi, Amir Hossein Behnoush, Azadeh Reshadmanesh, Amirmohammad Khalaji, Mitra Norouzi, Elmira Javanmardi, Reza Pishdad, S Reza Jafarzadeh, Elina Ghondaghsaz, Sandra Chaparro
{"title":"The effects of sodium-glucose cotransporter-2 inhibitors in chemotherapy-induced cardiotoxicity and mortality in patients with cancer: a systematic review and meta-analysis.","authors":"Tara Reshadmanesh, Reza Mohebi, Amir Hossein Behnoush, Azadeh Reshadmanesh, Amirmohammad Khalaji, Mitra Norouzi, Elmira Javanmardi, Reza Pishdad, S Reza Jafarzadeh, Elina Ghondaghsaz, Sandra Chaparro","doi":"10.1186/s40959-025-00343-4","DOIUrl":"10.1186/s40959-025-00343-4","url":null,"abstract":"<p><strong>Background: </strong>The effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on reducing cardiovascular events in different subgroups of diabetic patients are under investigation. The current systematic review and meta-analysis investigated the effects of SGLT2 inhibitors on preventing cardiovascular events and mortality and their adverse events in patients with active cancer and diabetes undergoing cardiotoxic cancer treatment.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Scopus to find studies investigating the effects of SGLT2 inhibitors on patients with diabetes and confirmed cancer until 19 August 2024. Meta-analyses were conducted using the random-effects model to compare all-cause mortality, cancer-associated mortality, heart failure (HF) hospitalization, arrhythmia, and adverse event rates such as ketoacidosis, hypoglycemia, urinary tract infection, and sepsis between patients with or without SGLT2 inhibitors use. Risk ratios (RRs) with 95% confidence intervals (CI) were used to compare outcomes between SGLT2 inhibitors and non-SGLT2 inhibitors groups.</p><p><strong>Results: </strong>Eleven studies were included with 88,096 patients with confirmed cancer (49% male). Among the total population, 20,538 received SGLT2 inhibitors (age 61.68 ± 10.71), while 67,558 did not receive SGLT2 inhibitors (age 68.24 ± 9.48). The meta-analysis found that the patients who received SGLT2 inhibitors had a significantly lower mortality rate than those who did not receive SGLT2 inhibitors (RR 0.46, 95% CI 0.34 to 0.63, p-value < 0.0001). Similarly, the cancer-associated mortality rate was also lower (RR 0.29, 95% CI 0.27 to 0.30, p-value < 0.0001). Further analysis found that the SGLT2 inhibitor group had a lower rate of HF hospitalization, compared to controls (RR 0.44, 95% CI 0.27 to 0.70, p-value = 0.0007). Moreover, patients receiving SGLT2 inhibitors had a statistically lower rate of arrhythmia (RR 0.38, 95% CI 0.26 to 0.56, p-value < 0.0001). Finally, patients in the SGLT2 inhibitors group had a lower rate of adverse events (RR 0.51, 95% CI 0.42 to 0.62, p-value < 0.0001).</p><p><strong>Conclusions: </strong>SGLT2 inhibitors are effective in reducing mortality (all-cause and cancer-associated), HF hospitalization, arrhythmia, and drug adverse events in patients with cancer. If confirmed in future studies, these agents could be a potentially ideal candidate to prevent cardiotoxicity of cancer therapies.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"50"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}