What question did this study set out to answer?

To evaluate the risk of incident heart failure, particularly heart failure with preserved ejection fraction, related to mean cardiac radiation dose from contemporary breast cancer radiotherapy.

January 30, 2017CirculationOpen Access

Risk of Heart Failure With Preserved Ejection Fraction in Older Women After Contemporary Radiotherapy for Breast Cancer

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Why the study?

Does increasing mean cardiac radiation dose increase the risk of incident heart failure in women undergoing radiotherapy for breast cancer?

Population

170 female residents of Olmsted County, Minnesota who underwent contemporary radiotherapy for breast cancer…

Comparison

Increasing mean cardiac radiation dose from… vs Lower mean cardiac radiation dose (MCRD)

Design

Case-control

Authors

HSHirofumi SaikiIwate Medical University IPIvy A. PetersenMayo Clinic CSChristopher G. ScottCardiac Imaging

Discussion

Member takes

Implication

May support cardiac dose minimization in breast radiotherapy; leaves open prospective confirmation of HF prevention.

Key Points

To evaluate the risk of incident heart failure, particularly heart failure with preserved ejection fraction, related to mean cardiac radiation dose from contemporary breast cancer radiotherapy.
Conducted a population-based case-control study of 170 women (59 incident heart failure cases and 111 matched controls) who underwent CT-planned radiotherapy for breast cancer between 1998 and 2013 in Olmsted County, Minnesota.
Controls were matched for age, tumor side, chemotherapy, diabetes, and hypertension, and individual mean cardiac radiation dose (MCRD) was reconstructed from CT radiotherapy plans.
Higher log MCRD was significantly associated with any incident heart failure (odds ratio 9.1, 95% CI 3.4–24.4) and specifically heart failure with preserved ejection fraction (odds ratio 16.9, 95% CI 3.9–73.7).
The odds ratio per log MCRD for heart failure with reduced ejection fraction was not statistically significant at 3.17 (95% CI 0.8–13.0), and only 18.6% of cases had intervening ischemic events before heart failure onset.

Structured PICO

Does increasing mean cardiac radiation dose increase the risk of incident heart failure in women undergoing radiotherapy for breast cancer?

Population

170 female residents of Olmsted County, Minnesota who underwent contemporary (1998-2013) radiotherapy for breast cancer with computed tomography-assisted radiotherapy planning (59 incident HF cases and 111 matched controls).

Intervention

Increasing mean cardiac radiation dose (MCRD) from contemporary breast cancer radiotherapy

Comparator

Lower mean cardiac radiation dose (MCRD)

Outcome

Incident heart failure (any HF, HFpEF, and HFrEF)hard clinical

Increasing cardiac radiation exposure during contemporary breast cancer radiotherapy is associated with a significantly increased risk of incident heart failure, particularly HFpEF.

Cite This Study

Saiki et al. (2017) studied this question.

synapsesocial.com/papers/69fbd6dddf6507d4845ddb2d https://doi.org/10.1161/circulationaha.116.025434

Topics

HFrEF treatment Heart failure

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Risk of Heart Failure With Preserved Ejection Fraction in Older Women After Contemporary Radiotherapy for Breast Cancer

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Risk of Heart Failure With Preserved Ejection Fraction in Older Women After Contemporary Radiotherapy for Breast Cancer

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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