Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines

Area of Science:

• Oncology
• Cardiology
• Health Disparities

Background:

• Anthracyclines are vital chemotherapy agents but pose a significant risk of cardiotoxicity, leading to increased morbidity and mortality in cancer patients.
• Understanding cardiotoxicity incidence and risk factors in diverse populations is crucial for equitable cancer care.

Purpose of the Study:

• To investigate the incidence of and risk factors for cardiotoxicity in a racially and ethnically diverse cohort of cancer patients treated with anthracyclines.
• To identify disparities in cardiotoxicity risk among different racial and ethnic groups.

Main Methods:

• Retrospective analysis of 743 adult patients undergoing anthracycline-based chemotherapy between 2016 and 2019.
• Cardiotoxicity defined as clinical heart failure or a ≥10% drop in left ventricular ejection fraction to ≤50%.
• Statistical analysis adjusted for cardiovascular risk factors, socioeconomic status, anthracycline dose, and baseline ejection fraction.

Main Results:

• Cardiotoxicity developed in 13.2% of patients over a median follow-up of 21 months.
• Incidence was significantly higher in Non-Hispanic Black (16.3%), Hispanic (14.7%), and Asian (18.2%) individuals compared to Non-Hispanic White (7.2%) individuals (P=0.024).
• Non-Hispanic Black and Hispanic individuals showed an independently higher risk (HR 2.62 and 2.37, respectively) and greater decline in left ventricular ejection fraction.

Conclusions:

• Non-Hispanic Black, Hispanic, and Asian individuals exhibit an elevated risk of cardiotoxicity following anthracycline treatment compared to their Non-Hispanic White counterparts.
• These findings highlight critical racial and ethnic disparities in cardiotoxicity risk that warrant further investigation and targeted interventions.