Why the study?
Anthracyclines increase heart failure and cardiomyopathy risk, prompting guidelines to recommend cardiac surveillance, but associations between racial and ethnic groups in surveillance uptake remained unclear.
Are there racial and ethnic differences in the receipt of guideline-recommended cardiac surveillance among cancer survivors treated with anthracyclines?
Are there racial and ethnic differences in the receipt of guideline-recommended cardiac surveillance among cancer survivors treated with anthracyclines?
Significant racial and ethnic disparities exist in the receipt of guideline-recommended cardiac surveillance before and after anthracycline-based chemotherapy, with Non-Hispanic Black and Hispanic patients receiving less surveillance than Non-Hispanic White patients.
Potential surveillance inequities merit clinical awareness; leaves open whether targeted interventions improve equity in anthracycline-treated survivors.
Background Anthracyclines remain a key treatment for many malignancies but can increase the risk of heart failure or cardiomyopathy. Specific guidelines recommend echocardiography and serum cardiac biomarkers such as BNP (B‐type natriuretic peptide) or NT‐proBNP (N‐terminal proBNP) evaluation before and 6 to 12 months after treatment. Our objective was to evaluate associations between racial and ethnic groups in cardiac surveillance of survivors of cancer after exposure to anthracyclines. Methods and Results Adult patients in the OneFlorida Consortium without prior cardiovascular disease who received at least 2 cycles of anthracyclines were included in the analysis. Multivariable logistic regression was performed to estimate the odds ratios (ORs) and 95% CIs for receiving cardiac surveillance at baseline before anthracycline therapy, 6 months after, and 12 months after anthracycline exposure among different racial and ethnic groups. Among the entire cohort of 5430 patients, 63.4% had a baseline echocardiogram, with 22.3% receiving an echocardiogram at 6 months and 25% at 12 months. Non‐Hispanic Black (NHB) patients had a lower likelihood of receiving a baseline echocardiogram than Non‐Hispanic White (NHW) patients (OR, 0.75 [95% CI, 0.63–0.88]; P =0.0006) or any baseline cardiac surveillance (OR, 0.76 [95% CI, 0.64–0.89]; P =0.001). Compared with NHW patients, Hispanic patients received significantly less cardiac surveillance at the 6‐month (OR, 0.84 [95% CI, 0.72–0.98]; P =0.03) and 12‐month (OR, 0.85 [95% CI, 0.74–0.98]; P =0.03) time points, respectively. Conclusions There were significant racial and ethnic differences in cardiac surveillance among survivors of cancer at baseline and following anthracycline‐based treatment in NHB and Hispanic cohorts. Health care providers need to be cognizant of these social inequities and initiate efforts to ensure recommended cardiac surveillance occurs following anthracyclines.
No takes yet. Share an insight, caveat, or question.
DeRemer et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: