ASPO Abstracts
Excess heart age among young breast cancer survivors over two-year follow-up
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: There are approximately 3.5 million breast cancer survivors (BCS) in the US.Approximately 10% are diagnosed “young” (<45 years). The overall 5-year survival rate for BCS is 90%. Livinglonger, BCS are at higher risk for developing cardiovascular disease (CVD) due to cancer treatment, such asanthracyclines and/or trastuzumab. The purpose of this study was to examine CVD risk, measured using excessheart age, among young BCS.Methods: This is a retrospective, 2-year cohort study using data from electronic medicalrecords of BCS diagnosed between 30-44 years of age and treated at UAB Hospital between 2012-2015. Heartage was calculated using actual age, systolic blood pressure, antihypertensive medication use,body mass index, diabetes status, and smoking status. Excess heart age, the difference between heart age and actualage, was examined at 2 time points: diagnosis and 2-year follow-up. Within-group mean comparison tests andlinear regression were conducted to compare excess heart age over two-year follow-up and identify predictors ofexcess heart age. Statistical analyses were conducted using R v3.2.2.Results: There were 152 young BCS, of which 95 received anthracyclines and/or trastuzumab(Group A/T) and 57 did not (Group No-A/T). Overall excess heart age was 4.2 to 5.4 years from diagnosis to2-year follow-up (p = .08). There was no significant difference in excess heart age from diagnosis to follow-upin Group A/T (4.3 to 4.4 years, p = .93); whereas Group No-A/T had a significant increase (4.0 to 7.1 years, p <.01). Factors that increased excess heart age included hormonal therapy and change from premenopausal topostmenopausal status.Conclusions: Among young BCS treated with anthracyclines and/or trastuzumab, there was nosignificant increase in excess heart age at follow-up; however, subclinical changes, undetected byheart age, may still occur. Group No-A/T had a significant increase of 3.1 years, which may be related to hormonaltherapy and change in menopause status. Hormone therapy is associated with weight gain, and early menopause maycontribute to increased excess heart age. Future research is needed to evaluate CVD risk over longerfollow-up and should consider incorporating cancer treatment risk factors into heart age.
Keywords: breast cancersurvivorship, cardiovascular risk,co-morbidities