Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study
Background Research on the cardiovascular toxicity of angiogenesis inhibitors among patients with cancer in Taiwan is lacking. This observational study explored the risk of major adverse cardiovascular events (MACEs) associated with angiogenesis inhibitors in Taiwan. Methods and Results We conducted...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.030263 |
| _version_ | 1797229310175608832 |
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| author | Yen‐Chou Chen Chun‐Yao Huang Li‐Ming Lien Jin‐Hua Chen Fang‐I Hsieh |
| author_facet | Yen‐Chou Chen Chun‐Yao Huang Li‐Ming Lien Jin‐Hua Chen Fang‐I Hsieh |
| author_sort | Yen‐Chou Chen |
| collection | DOAJ |
| description | Background Research on the cardiovascular toxicity of angiogenesis inhibitors among patients with cancer in Taiwan is lacking. This observational study explored the risk of major adverse cardiovascular events (MACEs) associated with angiogenesis inhibitors in Taiwan. Methods and Results We conducted a nested case‐control study using the TCR (Taiwan Cancer Registry) linked with the Taiwan National Insurance Claim Database. We matched every case with 4 controls using risk‐set sampling by index date, age, sex, cancer type, and cancer diagnosis date. Conditional logistic regression was used to evaluate the risks of MACEs and different cardiovascular events using propensity score adjustment or matching. Sensitivity analyses were used to evaluate the risks matched by cancer stages or exposure within 1 year. Among a cohort of 284 292 after the exclusion of prevalent cases, the incidences of MACEs among the overall cohort and those exposed to angiogenesis inhibitors were 22.5 and 32.5 events per 1000 person‐years, respectively. We matched 17 817 cases with 70 740 controls, with a mean age of 74.9 years, and 56.8% of patients were men. After propensity score adjustment, angiogenesis inhibitors were associated with increased risks of MACEs (odds ratio, 4.56; 95% CI, 1.78–11.59). Significantly increased risks were noted for heart failure hospitalization, myocardial infarction, cerebrovascular accident, and venous thromboembolism, but not for new‐onset atrial fibrillation. Similar results were observed after matching by cancer stage or restriction of 1‐year exposure. Conclusions Angiogenesis inhibitors were associated with increased risks of MACEs among patients with various malignancies in Taiwan but were not associated with new‐onset atrial fibrillation. |
| first_indexed | 2024-03-08T13:50:11Z |
| format | Article |
| id | doaj.art-4e9746eb03ca438fb1d06c388eb848ce |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:33Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-4e9746eb03ca438fb1d06c388eb848ce2024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.030263Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control StudyYen‐Chou Chen0Chun‐Yao Huang1Li‐Ming Lien2Jin‐Hua Chen3Fang‐I Hsieh4Division of Cardiology and Cardiovascular Research Centre Taipei Medical University Hospital Taipei TaiwanDivision of Cardiology and Cardiovascular Research Centre Taipei Medical University Hospital Taipei TaiwanSchool of Medicine, College of Medicine Taipei Medical University Taipei TaiwanGraduate Institute of Data Science, College of Management Taipei Medical University Taipei TaiwanSchool of Public Health, College of Public Health Taipei Medical University Taipei TaiwanBackground Research on the cardiovascular toxicity of angiogenesis inhibitors among patients with cancer in Taiwan is lacking. This observational study explored the risk of major adverse cardiovascular events (MACEs) associated with angiogenesis inhibitors in Taiwan. Methods and Results We conducted a nested case‐control study using the TCR (Taiwan Cancer Registry) linked with the Taiwan National Insurance Claim Database. We matched every case with 4 controls using risk‐set sampling by index date, age, sex, cancer type, and cancer diagnosis date. Conditional logistic regression was used to evaluate the risks of MACEs and different cardiovascular events using propensity score adjustment or matching. Sensitivity analyses were used to evaluate the risks matched by cancer stages or exposure within 1 year. Among a cohort of 284 292 after the exclusion of prevalent cases, the incidences of MACEs among the overall cohort and those exposed to angiogenesis inhibitors were 22.5 and 32.5 events per 1000 person‐years, respectively. We matched 17 817 cases with 70 740 controls, with a mean age of 74.9 years, and 56.8% of patients were men. After propensity score adjustment, angiogenesis inhibitors were associated with increased risks of MACEs (odds ratio, 4.56; 95% CI, 1.78–11.59). Significantly increased risks were noted for heart failure hospitalization, myocardial infarction, cerebrovascular accident, and venous thromboembolism, but not for new‐onset atrial fibrillation. Similar results were observed after matching by cancer stage or restriction of 1‐year exposure. Conclusions Angiogenesis inhibitors were associated with increased risks of MACEs among patients with various malignancies in Taiwan but were not associated with new‐onset atrial fibrillation.https://www.ahajournals.org/doi/10.1161/JAHA.123.030263angiogenesis inhibitorscardiotoxicitycardiovascular systemvascular endothelial growth factors |
| spellingShingle | Yen‐Chou Chen Chun‐Yao Huang Li‐Ming Lien Jin‐Hua Chen Fang‐I Hsieh Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease angiogenesis inhibitors cardiotoxicity cardiovascular system vascular endothelial growth factors |
| title | Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study |
| title_full | Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study |
| title_fullStr | Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study |
| title_full_unstemmed | Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study |
| title_short | Cardiovascular Toxicity of Angiogenesis Inhibitors Among Patients With Cancer in Taiwan: A Nested Case‐Control Study |
| title_sort | cardiovascular toxicity of angiogenesis inhibitors among patients with cancer in taiwan a nested case control study |
| topic | angiogenesis inhibitors cardiotoxicity cardiovascular system vascular endothelial growth factors |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.030263 |
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