Effect of standard low-dose anthracycline chemotherapy on late congestive heart failure in breast cancer survivors aged between 50 and 59 at diagnosis: A nationwide study.

Abstract

OBJECTIVES:

Although chemotherapy-induced congestive heart failure (CHF) is a well-known adverse event in cancer survivors, the long-term risk of standard low-dose anthracycline has not yet been reported. This study aimed to investigate the long-term effects of standard anthracycline on late CHF in breast cancer survivors.

MATERIALS AND METHODS:

A nationwide retrospective cohort study was conducted using the national insurance claims data for nearly 98% of Korean citizens. Between Jan 2010 and Dec 2015, a total of 56,338 newly diagnosed female breast cancer survivors were included.

RESULTS:

The total number of person-years was 199,648 and the incidence rate of late CHF was 3.57 per 1000 person-years. In multivariate analysis according to the subject's age at diagnosis, only in the 50-59 age group, anthracycline-based [hazard ratio (HR) 1.765, 95% confidence interval (CI) 1.206-2.583] and taxane plus anthracycline-based regimens (HR 1.816, 95% CI 1.192-2.768) significantly increased the risk of late CHF. In the 50-59 age group, standard low-dose anthracycline significantly increased the risk of late CHF (HR 1.627, 95% CI 1.080-2.451) in Cox proportional hazard regression models. In competing risk model with recurrence and in-hospital death as competing risks, standard low-dose anthracycline was a significant risk factor for late CHF [subdistribution hazard ratio (SHR) 1.553, 95% CI 1.029-2.340].

CONCLUSION:

This nationwide study showed that standard chemotherapy with low-dose anthracycline is a risk factor for late-onset CHF in breast cancer survivors who were in their 50 s at breast cancer diagnosis. Long-term monitoring of late CHF should be considered in these younger breast cancer survivors.

• Authors: Il Yong Chung, Jong Won Lee, Hyeong-Gon Moon, Kyung Hwan Shin, Wonshik Han, Byung Ho Son, Sei-Hyun Ahn, Dong-Young Noh
• Journal: Breast (Edinburgh, Scotland) (Breast) Vol. 53 Pg. 125-129 (Oct 2020) ISSN: 1532-3080 [Electronic] Netherlands
• PMID: 32771950 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Anthracyclines
• Antineoplastic Agents
• Bridged-Ring Compounds
• Taxoids
• taxane

Topics

• Age Factors
• Anthracyclines (adverse effects)
• Antineoplastic Agents (adverse effects)
• Breast Neoplasms (drug therapy)
• Bridged-Ring Compounds (adverse effects)
• Cancer Survivors
• Female
• Heart Failure (chemically induced)
• Humans
• Incidence
• Middle Aged
• Proportional Hazards Models
• Republic of Korea (epidemiology)
• Retrospective Studies
• Risk Factors
• Taxoids (adverse effects)