Effect of primary prevention on major adverse cardiac event in breast cancer patients on cytotoxic chemotherapy

Clicks: 1
ID: 323350
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #159 of 282 articles by views in European heart journal supplements : journal of the European Society of Cardiology

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 282 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Advances in cancer detection and treatment have improved 5-year survival rates, creating a growing population of cancer survivors. However, multi-modal therapies carry cardiotoxic risks, and cardiovascular events during treatment can interrupt curative care and increase morbidity, healthcare costs, and mortality. We evaluated the real-world effectiveness of primary prevention with cardioprotective pharmacological therapy on major adverse cardiovascular events (MACE) among adults with breast cancer receiving cytotoxic chemotherapy. Methods We conducted a retrospective cohort study within a large integrated healthcare delivery system. Adult members (≥18 years) diagnosed with primary breast cancer between January 2007 and December 2022 were identified through the cancer registry. Eligible patients maintained continuous health plan enrollment prior to diagnosis and received cytotoxic chemotherapy. Covariates, exposure, and outcome data were extracted from electronic medical records. MACE was defined as a composite of myocardial infarction, stroke, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, and all-cause mortality. Primary prevention exposure was based on prescription fills for cardioprotective pharmacological therapy during the 12 months preceding chemotherapy initiation. Parametric survival models were adjusted for demographics, lifestyle factors, tumor characteristics, insurance type, primary breast cancer surgery, and comorbidities. To address non-randomized treatment assignment, we applied the potential outcomes framework using a control function derived from a first-stage treatment selection model with two instrumental variables: (1) the number of cardiologists at the patient’s treatment center and (2) lagged prescribing preferences for cardioprotective medications among prior breast cancer patients at the same center. Statistical inference used 1,000 bootstrap replications with bias-corrected confidence intervals. Patients were followed until MACE, disenrollment, or end of follow-up (December 2025). Results Among 12,203 patients, median follow-up after chemotherapy initiation was 6.6 years (mean 7.5; maximum 19). Over 91,636 person-years, 2,434 patients experienced a MACE (26.6 per 1,000 person-years). Primary prevention with cardioprotective pharmacological therapy was associated with a 95% longer time to MACE versus no therapy (Time Ratio = 1.95; 95% CI: 1.15–4.21). Conclusions Among breast cancer patients receiving cytotoxic chemotherapy, primary prevention with cardioprotective pharmacological therapy was significantly associated with prolonged time to major adverse cardiovascular events. These findings support proactive cardioprotective strategies to mitigate treatment-related cardiovascular risk and reinforce the value of integrating preventive cardiology into cardio-oncology care pathways.
Reference Key
openalex_W7172309690 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors A Kawatkar, A Baecker, E Estrada, B Bhakta, J Pio, D Yi
Journal European heart journal supplements : journal of the European Society of Cardiology
Year 2026
DOI
10.1093/eurheartjsupp/suag097.084
URL
https://doi.org/10.1093/eurheartjsupp/suag097.084
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.