Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs

Background: Little is known about the characteristics of oncological patients, cancer therapy-induced cardiotoxicity, and guidelines-directed interventions in the Caribbean; analysis of cardio-oncology services may shed light on this and clarify links between ethnicity, cultural, and local socioecon...

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Main Authors: Pamela Piña, Amparo Taveras, Amir Khan, Justin Coyle, Victor Bueno, Nishit Shah, Luis Cuello, Santiago Collado, Ann Mauer, Sorin Danciu, Cesar J. Herrera
Format: Article
Language:English
Published: Ubiquity Press 2022-09-01
Series:Global Heart
Subjects:
Online Access:https://globalheartjournal.com/articles/1153
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author Pamela Piña
Amparo Taveras
Amir Khan
Justin Coyle
Victor Bueno
Nishit Shah
Luis Cuello
Santiago Collado
Ann Mauer
Sorin Danciu
Cesar J. Herrera
author_facet Pamela Piña
Amparo Taveras
Amir Khan
Justin Coyle
Victor Bueno
Nishit Shah
Luis Cuello
Santiago Collado
Ann Mauer
Sorin Danciu
Cesar J. Herrera
author_sort Pamela Piña
collection DOAJ
description Background: Little is known about the characteristics of oncological patients, cancer therapy-induced cardiotoxicity, and guidelines-directed interventions in the Caribbean; analysis of cardio-oncology services may shed light on this and clarify links between ethnicity, cultural, and local socioeconomic factors. Objectives: This study compared patients’ phenotypes, adherence to guidelines recommendations, and patterns of cardiotoxicity between two cardio-oncology programs: one in the Dominican Republic (DR) and the other in Chicago IL, United States (US). Methods: Patients being considered for or treated with potentially cardiotoxic drugs were followed before, during, and after chemotherapy through both cardio-oncology clinics, where we recorded and compared clinical, demographic, and echocardiographic data. Results: We studied 597 consecutive patients, 330 (55%) from the DR and 267 (45%) from the US. DR vs. US mean age 55± 13/52 ± 13 years; female 77/87% (p < 0.001); breast cancer 57/73% (p < 0.001); treated with anthracyclines + taxanes 47/40% (p = 0.151); monoclonal antibodies + taxanes or platins 37/45% (p < 0.001). Cardiotoxicity DR vs. US occurred in 15/7% (p = 0.001); multivariate logistic regression (OR 2.29; 95% CI, 1.31–3.99; p < 0.005) did not identify age >60, HTN, DM, BMI, tobacco or chemotherapy as predictors. Compliance with ASCO guidelines was similar among both cohorts. Conclusion: Compared to the US cohort, the Caribbean cohort of cancer patients has similar rates of CV risk factors but a higher likelihood of developing drug-induced LV dysfunction. Programs’ compliance with ASCO guidelines was equivalent. While further research is needed to ascertain regional variations of cardiotoxicity, these findings underline the relevance of cardio-oncology services in nations with limited resources and high CV risk.
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spelling doaj.art-e6d7aaf9734b47f0a09d12d1ca7204eb2022-12-22T02:24:25ZengUbiquity PressGlobal Heart2211-81792022-09-0117110.5334/gh.1153974Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology ProgramsPamela Piña0Amparo Taveras1Amir Khan2Justin Coyle3Victor Bueno4Nishit Shah5Luis Cuello6Santiago Collado7Ann Mauer8Sorin Danciu9Cesar J. Herrera10Department of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoDepartment of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoSection of Cardiology, Advocate Illinois Masonic Medical Center, ChicagoSection of Cardiology, Advocate Illinois Masonic Medical Center, ChicagoDepartment of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoSection of Cardiology, Advocate Illinois Masonic Medical Center, ChicagoDepartment of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoDepartment of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoSection of Cardiology, Advocate Illinois Masonic Medical Center, ChicagoSection of Cardiology, Advocate Illinois Masonic Medical Center, ChicagoDepartment of Cardiology, CEDIMAT Cardiovascular Center, Santo DomingoBackground: Little is known about the characteristics of oncological patients, cancer therapy-induced cardiotoxicity, and guidelines-directed interventions in the Caribbean; analysis of cardio-oncology services may shed light on this and clarify links between ethnicity, cultural, and local socioeconomic factors. Objectives: This study compared patients’ phenotypes, adherence to guidelines recommendations, and patterns of cardiotoxicity between two cardio-oncology programs: one in the Dominican Republic (DR) and the other in Chicago IL, United States (US). Methods: Patients being considered for or treated with potentially cardiotoxic drugs were followed before, during, and after chemotherapy through both cardio-oncology clinics, where we recorded and compared clinical, demographic, and echocardiographic data. Results: We studied 597 consecutive patients, 330 (55%) from the DR and 267 (45%) from the US. DR vs. US mean age 55± 13/52 ± 13 years; female 77/87% (p < 0.001); breast cancer 57/73% (p < 0.001); treated with anthracyclines + taxanes 47/40% (p = 0.151); monoclonal antibodies + taxanes or platins 37/45% (p < 0.001). Cardiotoxicity DR vs. US occurred in 15/7% (p = 0.001); multivariate logistic regression (OR 2.29; 95% CI, 1.31–3.99; p < 0.005) did not identify age >60, HTN, DM, BMI, tobacco or chemotherapy as predictors. Compliance with ASCO guidelines was similar among both cohorts. Conclusion: Compared to the US cohort, the Caribbean cohort of cancer patients has similar rates of CV risk factors but a higher likelihood of developing drug-induced LV dysfunction. Programs’ compliance with ASCO guidelines was equivalent. While further research is needed to ascertain regional variations of cardiotoxicity, these findings underline the relevance of cardio-oncology services in nations with limited resources and high CV risk.https://globalheartjournal.com/articles/1153cardio-oncology
spellingShingle Pamela Piña
Amparo Taveras
Amir Khan
Justin Coyle
Victor Bueno
Nishit Shah
Luis Cuello
Santiago Collado
Ann Mauer
Sorin Danciu
Cesar J. Herrera
Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
Global Heart
cardio-oncology
title Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
title_full Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
title_fullStr Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
title_full_unstemmed Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
title_short Comparison of Patients’ Phenotypes, Guideline-Directed Recommendations Compliance and Rates of Cardiotoxicity between Caribbean and United States Cardio-oncology Programs
title_sort comparison of patients phenotypes guideline directed recommendations compliance and rates of cardiotoxicity between caribbean and united states cardio oncology programs
topic cardio-oncology
url https://globalheartjournal.com/articles/1153
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