Sleep apnea an early predictor of cancer therapy-related heart failure
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Key takeaways:
- Sleep apnea may be prognostic of cancer therapy-related cardiotoxicity.
- Sleep apnea was more prevalent than other CV risk factors currently used to risk-stratify patients.
Sleep apnea could be an early indicator of cancer therapy-related cardiomyopathy, according to new data presented at the American College of Cardiology Advancing the Cardiovascular Care of the Oncology Patient course.
“Echocardiogram has evolved to be a useful tool to detect and therefore treat cardiomyopathy early in patients with sleep apnea and in the cardio-oncology population, so we also wanted to see if there are shared echo markers that identify patients who are at greater risk as they start their journey to treat their cancer,” Mini K. Das, MD, medical director of the cardio-oncology program at Baptist Health in Louisville, Kentucky, said in a press release. “Identifying these individuals may allow early intervention in a risk factor clearly associated with heart failure now recognized to affect cancer therapy and survivorship.”
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Das and colleagues evaluated whether sleep apnea — also a cause of left ventricular dysfunction, congestive HF and abnormal global longitudinal strain — could be a risk factor for adverse CV outcomes among patients with cancer.
The researchers collected data from patients at a community cardiology practice and categorized them into two groups: general cardiology (n = 296) and cardio-oncology (n = 240).
The researchers assessed traditional CV risk factors, STOP-BANG score and whether the patient underwent a prior sleep study, and they compared the prevalence of risk factors with prevalence of sleep apnea in the general cardiology and cardio-oncology groups.
The cardio-oncology group underwent echocardiography to assess baseline LV ejection fraction and global longitudinal strain.
The prevalence of sleep apnea was 54% in the general cardiology group and 35% in the cardio-oncology group.
Das and colleagues reported that the prevalence of sleep apnea in the cardio-oncology group was higher than several other traditional risk factors utilized in risk stratification for cardiotoxicity.
LV ejection fraction was nearly the same among those in the cardio-oncology group with treated and untreated sleep apnea or with high STOP-BANG scores, but global longitudinal strain was abnormal in patients with untreated sleep apnea or with high STOP-BANG scores.
“Sleep apnea should be incorporated into current risk algorithms and a larger study is needed to evaluate the impact of sleep apnea in this high-risk population. We feel that sleep apnea assessment must be a part of routine risk assessment for patients undergoing cancer therapeutics,” Das said in the release.
Reference:
- Data shows significant prevalence of sleep apnea among cardio-oncology patients. https://www.acc.org/About-ACC/Press-Releases/2024/02/09/17/34/Data-Shows-Significant-Prevalence-of-Sleep-Apnea-Among-Cardio-Oncology-Patients. Published Feb. 9, 2024. Accessed Feb. 9, 2024.
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Das MK, et al. Clinical science in cardio-oncology (collection of evidence to establish treatment). Presented at: American College of Cardiology Advancing the Cardiovascular Care of the Oncology Patient course; Feb. 9-11, 2024; Washington, D.C.
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