Increased risk of cardiovascular death in breast cancer patients without chemotherapy or (and) radiotherapy: a large population-based study.

Abstract

Background Cardiovascular death (CVD) in breast cancer patients without chemotherapy or (and) radiotherapy has not been studied yet. This study evaluates the correlation between breast cancer and CVD risk independent of chemotherapy (CT) or (and) radiotherapy (RT). Methods Data of female breast cancer patients without receiving CT or RT were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004–2015). Data were divided into two cohorts: Patients who underwent tumor resection (resection cohort) and those who didn’t undergo resection (no resection cohort). The CVD risk in patients was expressed as standardized mortality ratios (SMRs). A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and competing risk regressions were utilized to evaluate the impact of tumor resection on CVD. Results The CVD risk was significantly higher (SMR = 2.196, 95% CI:2.148–2.245, P < 0.001) in breast cancer patients who did not receive CT or RT compared to the general population. Breast cancer patients who did not undergo tumor resection showed a higher CVD risk than patients who underwent tumour resection (tumor resection SMR = 2.031, 95% CI: 1.983–2.079, P < 0.001; no resection SMR = 5.425, 95% CI:5.087–5.781, P < 0.001). After PSM, the CVD risk among patients without tumor resection indicated an increase of 1.165-fold compared to the patients with tumor resection (HR = 1.165, 95% CI: 1.039–1.306, P = 0.009). Conclusions Female breast cancer patients are at higher risk of CVD despite unexposure to cardio-toxic CT or RT. However, female breast cancer patients subjected to tumor resection have decreased CVD risk. This study suggests that monitoring female breast cancer patients not receiving RT or CT might serve as a preventative measure against CVD.

Association of Digoxin Application Approaches With Long-Term Clinical Outcomes in Rheumatic Heart Disease Patients With Heart Failure: A Retrospective Study

“…The 1:1 propensity score matching (PSM) and statistical analyses were executed by SPSS version 24 (SPSS, Chicago, IL). The 1:1 PSM was executed referring to our previous methods (16) by baseline characteristics at enrollment such as age at diagnosis, age of surgery, disease duration, follow-up time, levels of systolic/diastolic blood pressure (SBP/DBP) and heart rate (Hr), surgical intervention, cardiac valve damage, NYHA, medical condition, combined medication, blood test index, and echocardiographic index. The caliper width was 0.1 for PSM.…”