SPC365

Morbidity and mortality of cardio-oncology patients: is there any link to baseline cardiovascular risk?

Session: Sessão de Posters 12 - Cardio-oncologia e Medicina na Gravidez
Speaker: Beatriz Andrade

Congress: CPC 2024
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.6 Cardio-Oncology
Session Type: Cartazes
FP Number: ---
Authors: Beatriz Vargas Andrade; Bruno Castilho; Nuno Cotrim; Catarina Gonçalves Coelho; Rita Veiga; Mariana Saraiva; Sandra Bento; Vítor Martins
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Cancer therapy-related cardiovascular toxicity (CTR-CVT) is one of the most significant adverse effects of cancer treatment, responsible for considerable morbidity and mortality. Efforts to lessen the morbidity of CTR-CVT have included better recognition of baseline patient risk factors and improvement of prevention and surveillance strategies.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Purpose:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> To evaluate the association between baseline cardiovascular risk (BCVR) - calculated by assessment tools published by Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society (HFA-ICOS) - with morbidity and mortality in a Portuguese population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Retrospective study of a population submitted to cancer therapy classes evaluated for BCVR according to HFA-ICOS assessment tool. CTR-CVT was defined according to 2022 ESC CO guidelines. Primary endpoint was the occurrence of all-cause hospitalization or mortality during follow-up (FU). For patients (pts) treated both with anthracyclines (AC) and HER2-targeted therapies (anti-HER2), the baseline risk was calculated by the proforma for anti-HER2.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> We included 75 pts, mean age 62.3&plusmn;10.6 years, 84% female, with mean FU of 34 months. The majority (80%)&nbsp;had breast cancer, followed by gastrointestinal (6.7%) and prostate (4%) malignancies. A significant proportion had advanced disease (33.3% were metastatic). Regarding chemotherapy regimens, 44% were exposed to AC, 36% to AC plus anti-HER2, and 8% only to anti-HER2. Also, 8% received VEGF inhibitors and 4% androgen deprivation therapies. 28% had low BCVR, 36% intermediate risk, 24% high risk and 12% very high risk. 30% of the patients were treated with cardioprotective drugs prior to CTR-CVT, mostly due to comorbidities.&nbsp;</span></span></span></span><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">22.7% of patients had a diagnosis of CTR-CVT, mainly in the form of left ventricular systolic dysfunction. Of these, 58.8% were symptomatic. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">36% of patients reached the endpoint: 28% of patients had &ge;1 hospital admission and 26.7% died during FU. Hospitalization and death were significantly more frequent in men (p=0.003 and p&lt;0.001 respectively) and metastatic cancer pts (p&lt;0.01 and p&lt;0.01 respectively). There was no association between BCVR and all-cause hospitalization, but an association between BCVR and all-cause mortality was found (p 0.016). There was no statistically significant difference&nbsp;between the use of statins, beta-blockers or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at baseline and the primary endpoint. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">In our population, BCVR correlated with mortality during FU, which was more frequent in men and metastatic cancer pts. That reinforces the value of a multidisciplinary approach in these patients, where BCVR prevention strategies can have a major prognostic role. </span></span></span></span></p>