Black patients may be at elevated cardiotoxicity, HF risk after chemotherapy
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Key takeaways:
- Black race was associated with 71% greater odds of chemotherapy-related cardiotoxicity vs. white or non-Black race.
- Black race was also associated with 92% greater odds of congestive HF after chemotherapy.
Results of a large meta-analysis indicated that Black race was associated with greater odds of cardiotoxicity and HF diagnosis after chemotherapy compared with white and non-Black race, a speaker reported.
The results of the meta-analysis were presented at the American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient conference.
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“Unfortunately, we were not surprised [by the findings]. Research shows that Black patients have poorer outcomes for almost every disease,” Wondewossen Gebeyehu, BSc, medical student at the University of Toronto, said in a press release. “In this case, one could have expected that the differences would be minimal since it is the chemotherapy that is injuring the heart, and we would expect the same chemotherapy to be given to Black and non-Black patients with a given cancer. However, this systematic review indicates that the inequities in health outcomes extends to the odds of cardiotoxicity after cancer treatment.”
Gebeyehu and colleagues identified 24 studies that reported CV events after chemotherapy among 683,749 patients with cancer from varying racial/ethnic backgrounds.
The most common cancer diagnosis was breast cancer, followed by prostate cancer, kidney cancer and hematological malignancies, including leukemia and lymphoma, according to the presentation.
Cancer therapies included anthracyclines, trastuzumab (Herceptin, Genentech) and hormonal therapies.
Gebeyehu and colleagues used inverse-variance weighting incorporating random effects to estimate the likelihood of adverse CV outcomes among Black patients relative to white or other non-Black patients after chemotherapy.
The researchers reported that Black race or African ancestry was associated with 71% greater odds of chemotherapy-related cardiotoxicity compared with white or non-Black race (unadjusted OR = 1.71; 95% CI, 1.4-2.1; I2 = 24%).
Moreover, Black race or African ancestry was also associated with 92% greater odds of congestive HF after chemotherapy compared with white or non-Black race (unadjusted OR = 1.92, 95% CI, 1.68-2.19; I2 = 0%), according to the presentation.
“The most important message for patients is that they should not avoid chemotherapy, as the most important thing is making sure they get the best cancer treatment possible, and studies already show Black patients may get less optimal cancer treatments,” Gebeyehu said. “For clinicians, it is important to be aware of these higher odds of cardiotoxicity faced by Black patients. Understanding these disparities will hopefully lead to clinicians having more conversations around reducing cardiovascular risk associated with chemotherapy and targeted efforts to cater to groups at higher risk.”
Reference:
- Black cancer patients 71% more likely to experience heart damage following chemotherapy treatment. https://www.acc.org/Latest-in-Cardiology/Articles/2023/04/14/13/11/Advancing-the-CV-Care-of-the-Oncology-Patient. Published April 14, 2023. Accessed April 14, 2023.
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Gebeyehu W, et al. Original Research Abstract 56. Presented at: American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient conference; April 14-16, 2023; Washington, D.C. (hybrid meeting).
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