Author + information
- Yan Gong,
- Hoai Nguyen,
- Anita Szady,
- Issam Hamadeh,
- Gloria Lipori,
- Qian Sun,
- Rhonda Cooper-DeHoff,
- Taimour Y. Langaee,
- Chintan Shah,
- Carl Pepine,
- Alexandra Lucas and
- Jan Moreb
Background: Targeted anticancer therapy associated cardiomyopathy is an increasingly recognized serious adverse effect among cancer survivors. The purpose of this study is to estimate the incidence of cardiomyopathy associated with targeted therapies using the Integrated Data Repository (IDR) from the University of Florida healthcare system (UF Health).
Methods: Relevant patient data from 2011 to May 2016 was extracted from the UF Health IDR. All patients who received antineoplastic drugs and all patients with a diagnosis of any heart disease were included. Patients with a cardiomyopathy diagnosis after the initiation date of the targeted therapies were identified using ICD-9 and ICD-10 codes. Incidences of cardiomyopathy following exposure to each drug and drug class were estimated. Multivariable Cox regression analysis was performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the targeted therapy classes adjusting for age, gender, and comorbidities associated with cardiomyopathy such as hypertension and diabetes. All analyses were performed in SAS v 9.4 (Cary, NC).
Results: A total of 2,637 patients were exposed to targeted therapies and among those a diagnosis of cardiomyopathy was identified in 107 patients following initiation of targeted therapies. Cardiomyopathy incidence was highest among patients treated with proteasome inhibitors (10.4%) and anti-HER2 inhibitors (7.7%), while the incidences were lowest among those treated with immunomodulatory agents (1.9%). Compared with those treated with anthracyclines, patients treated with anti-HER2 inhibitors and proteasome inhibitors had higher risk for cardiomyopathy; adjusted HR 3.3 (95% CI 1.6 – 6.6) (p = 0.0009) and 2.6 (1.4 – 5.0) (p = 0.003), respectively.
Conclusions: Incidence of target therapy associated cardiomyopathy was highest in those treated with proteasome inhibitors and anti-HER2 inhibitors. Our study provides important preliminary data applicable to clinical practice and is useful for the future design of studies to identify risk factors including genetic markers that could potentially predispose patients to targeted therapy associated cardiomyopathy.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-258
- 2017 American College of Cardiology Foundation