Key result
In patients with cancer treated with anticancer agents, the prevalence of heart failure was 4.0%, with patients aged ≥75 years having a significantly higher risk of developing heart failure compared to those ≤64 years (HR 1.67).
Why the study?
Comorbidity of heart failure in cancer survivors is a serious concern, prompting the need to examine risk factors for heart failure development after anticancer agent treatment across age groups.
Cohort (n=140,327)
Yes
Hazard Ratio: 1.67 (95% CI 1.51–1.85)
p-value: p=<0.01
Machine learning analysis of a large Japanese cohort reveals that risk factors for heart failure following anticancer therapy are highly age-dependent, highlighting the need for age-specific risk stratification in cardio-oncology.
May warrant heightened HF surveillance in elderly cancer patients; leaves open prospective validation of age-specific risk stratification.
As the prognosis of cancer patients has been improved, comorbidity of heart failure (HF) in cancer survivors is a serious concern, especially in the aged population. This study aimed to examine the risk factors of HF development after treatment by anticancer agents, using a machine learning-based analysis of a massive dataset obtained from the electronic health record (EHR) in Japan. This retrospective, cohort study, using a dataset from 2008 to 2017 in the Diagnosis Procedure Combination (DPC) database in Japan, enrolled 140,327 patients. The structure of risk factors was determined using multivariable analysis and classification and regression tree (CART) algorithm for time-to-event data. The mean follow-up period was 1.55 years. The prevalence of HF after anticancer agent administration were 4.0%. HF was more prevalent in the older than the younger. As the presence of cardiovascular diseases and various risk factors predicted HF, CART analysis of the risk factors revealed that the risk factor structures complicatedly differed among different age groups. The highest risk combination was hypertension, diabetes mellitus, and atrial fibrillation in the group aged ≤ 64 years, and the presence of ischemic heart disease was a key in both groups aged 65-74 years and 75 ≤ years. The machine learning-based approach was able to develop complicated HF risk structures in cancer patients after anticancer agents in different age population, of which knowledge would be essential for realizing precision medicine to improve the prognosis of cancer patients.
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Nohara et al. (2023) conducted a cohort in Cancer (n=140,327). Anticancer agents and cardiovascular risk factors vs. Reference groups (e.g., age ≤64 years) was evaluated on Heart failure development (age ≥75 vs ≤64 years) (HR 1.67, 95% CI 1.51-1.85, p=<0.01). In patients with cancer treated with anticancer agents, the prevalence of heart failure was 4.0%, with patients aged ≥75 years having a significantly higher risk of developing heart failure compared to those ≤64 years (HR 1.67).
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