Abstract 20164: Leukemia is Associated With a High Prevalence of Major Adverse Cardiac Events After Anthracycline-Based Chemotherapy
Background: Leukemia is a systemic disease with high pro-inflammatory cytokines release and possible direct leukemic cells infiltration of the heart. The objective of the study was to investigate whether leukemia is associated with major adverse cardiac event (MACE) in a cohort of cancer patients after anthracycline-based chemotherapy.
Methods: We studied 2285 consecutive cancer patients who underwent an echocardiogram before anthracyclines therapy. Major adverse cardiac events (MACE) were defined based on examination of the records as cardiac death or symptomatic heart failure. Cox regression analysis without and with adjustment for baseline characteristics was used to determine the variables associated with MACE.
Results: The baseline characteristics of patients with leukemia and other types of cancer are summarized in the Table. Sixty five patients (2.8%), had a MACE over a follow-up period of 706 (235-1665) days. The incidence rate of MACE was 8 times higher in leukemia patients (55.3 events/1000 person-years) than other types of cancer (7.0 events/1000 person-years). In a multivariate analysis, after adjustment for age, gender, cardiovascular history, risk factors, treatment, left ventricular ejection fraction and cumulative dose of anthracyclines, leukemia was significantly and independently related to MACE (HR: 9.0; 95% CI: 4.7 - 17; p< 0.001).
Conclusion: In our cohort of cancer patient treated with anthracycline-based chemotherapy, leukemia was associated with increased risk of cardiac death or symptomatic heart failure independently of cardiovascular risk factors and dose of anthracyclines. This findings suggest that leukemia by itself is related to a high prevalence of MACE in this patients.
Author Disclosures: B.M. Assuncao: None. L. Wang: None. M. Scherrer-Crosbie: None.
- © 2016 by American Heart Association, Inc.