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The long-term effect of age on cardiovascular disease in patients with breast cancer who received chemotherapy

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Abstract

Purpose

As breast cancer survival has significantly improved and patient life expectancy has increased, greater numbers of elderly breast cancer survivors are at risk for cardiovascular disease (CVD). Therefore, this study investigated the impact of age on the incidence, mortality, and predictors of CVD following adjuvant chemotherapy in the late period of survivorship.

Methods

761 Patients who underwent chemotherapy were enrolled and divided into patients aged < 50 years (n = 413, 54.3%) and patients aged ≥ 50 years (n = 348, 45.7%). Among the entire cohort, 445 patients underwent transthoracic echocardiography.

Results

During long-term follow-up (median 122 months, range 12–340 months), CVD events developed in 50 (6.57%) patients, including 17 (4.1%) aged < 50 years and 33 (9.5%) aged ≥ 50 years (p = 0.003). 8 (1.1%) of 50 patients with CVD died, including 1 patient aged < 50 years and 7 patients aged ≥ 50 years. CVD-free survival was significantly lower in patients aged ≥ 50 years compared with patients aged < 50 years (p < 0.001). In multivariate analyses, age ≥ 50 years [p < 0.001, hazard ratio (HR) = 3.802, 95% confidence interval (CI) 1.986–7.278], the radio of the peak early and mitral tissue Doppler velocities (p = 0.014, HR = 1.102, 95% CI 1.020–1.190), and global longitudinal strain (p < 0.001, HR = 1.208, 95% CI 1.096–1.332) are significant predictors of CVD.

Conclusions

Age, diastolic function, and strain value in patients with breast cancer who underwent chemotherapy has a long-term effect on CVD. Therefore, it is important to consider ethnic and age-specific risks for CVD in breast cancer survivors.

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Funding

This work received no funding.

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Authors and Affiliations

  1. Department of Surgery, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Republic of Korea

    Ye Won Jeon & Young Jin Suh

  2. Department of Surgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Hye Won Bang

  3. Division of Cardiology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon, 16247, Republic of Korea

    GeeHee Kim

Authors
  1. Ye Won Jeon
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Contributions

Study design and concept: YWJ, GHK. Data acquisition: YWJ, GHK, HWB, YJS. Data analysis and interpretation: YWJ, GHK. Manuscript preparation and editing: YWJ, GHK. Manuscript review: YWJ, GHK.

Corresponding author

Correspondence to GeeHee Kim.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were conducted in accordance with the Ethics Standards of the Institutional or National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethics standards. This study was approved by the Institutional Review Board (IRB) of St. Vincent’s Hospital, Catholic University of Korea (VC19RISI0266).

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Informed consent was obtained from all individual participants included in this study.

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Jeon, Y.W., Bang, H.W., Suh, Y.J. et al. The long-term effect of age on cardiovascular disease in patients with breast cancer who received chemotherapy. Breast Cancer Res Treat 180, 665–674 (2020). https://doi.org/10.1007/s10549-020-05568-8

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  • DOI: https://doi.org/10.1007/s10549-020-05568-8

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