Risk factors and protective strategies for cancer treatment-associated cardiotoxicity

Abstract

Survival with cancer has dramatically improved over the last few years. The increased survival with cancer has driven a renewed focus on minimizing cardiovascular sources of morbidity and mortality. Consistent data have shown that cancer patients are at an increased rate of cardiovascular disease, likely due to the effects of cancer therapies, underlying cancer biology, and cardiovascular risk factors. The occurrence of these cardiovascular events affects the survival and quality of life of patients, hence necessitating the need to better identify and manage cancer-associated cardiotoxicity. In my first project, I examined the incidence and risk factors associated with the use of immune checkpoint inhibitors. Immune checkpoint inhibitors are associated with adverse cardiovascular events, but there are no data characterizing immune checkpoint inhibitor-associated cardiovascular events among Asians. To address this knowledge gap, I performed a retrospective, propensity score-matched cohort study at two tertiary referral centers in Taiwan to describe the incidence and identify clinical factors associated with immune checkpoint inhibitor-associated cardiovascular events. In my second project, I evaluated the effects of sodium-glucose cotransporter 2 inhibitors on cardiovascular diseases and mortality in patients with cancer. Sodium-glucose cotransporter 2 inhibitors have been found to protect against cardiovascular outcomes, principally heart failure, in the non-cancer population. Their effects on heart failure in the cancer population are unknown. Furthermore, preclinical studies suggest an antitumor effect associated with sodium-glucose cotransporter 2 inhibitors. I conducted a retrospective, propensity score-matched cohort study at two tertiary referral centers in Taiwan to evaluate the effects of sodium-glucose cotransporter 2 inhibitors on the risk of cardiovascular outcomes and all-cause mortality.