Cardiovascular Disease Risk in Survivors of Breast Cancer

Sharma, Avinash V.; Reddin, Gemma; Forrestal, Brian J.; Barac, Ana

doi:10.1007/s11936-019-0788-2

Cited by 8 publications

(6 citation statements)

References 93 publications

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“…Such conditions may occur due to the higher prevalence of risk factors for CVDs, such as dyslipidemia, abdominal adiposity, systemic arterial hypertension (SAH) and diabetes mellitus (DM) [ 4 , 5 ]. In addition, antineoplastic treatments, such as chemotherapy (CT) with anthracycline, radiotherapy and endocrine therapy, can lead to cardiotoxicity [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer Survivors Undergoing Endocrine Therapy Have a Worrying Risk Factor Profile for Cardiovascular Diseases

et al. 2021

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The increased risk for cardiovascular diseases (CVDs) in breast cancer survivors has been widely discussed in the literature and occurs due to the cardiotoxicity of antineoplastic treatments, and also to the common risk factors between these diseases. Thus, the objective of our study was to evaluate, prospectively, the number of risk factors (NRF) for CVDs in women during endocrine therapy, and to associate the NRF with C reactive protein (CRP) and phase angle (PhA). The following risk factors for CVD were evaluated at three times: anthracycline chemotherapy, radiotherapy, comorbidities, inadequate diet, overweight, abdominal adiposity, alcoholism, smoking, physical inactivity and altered lipid profile. There was inadequacy in the most components of the Brazilian Healthy Eating Index—Revised and inadequate consumption of various types of fats and fibers. Most women in this study presented excessive abdominal fat and overweight, but these parameters have not changed over time (p < 0.005). Moreover, a high frequency of systemic arterial hypertension and physical inactivity was observed. The average NRF for CVDs was above ten, at the three evaluation times. Women with higher NRF had higher levels of CRP (p = 0.003), a predictor of cardiovascular risk, however, there was no significance with PhA (p = 0.256). Thus, intervention is needed to improve lifestyle.

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Section: Introductionmentioning

confidence: 99%

Breast Cancer Survivors Undergoing Endocrine Therapy Have a Worrying Risk Factor Profile for Cardiovascular Diseases

et al. 2021

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“…These results are consistent with the known risk factors of cardiotoxicity associated with trastuzumab and other HER2-targeted therapies, with anthracycline use being an important risk factor. 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

Cardiac safety of dual anti-HER2 blockade with pertuzumab plus trastuzumab in early HER2-positive breast cancer in the APHINITY trial

Azambuja¹,

Agostinetto²,

Procter³

et al. 2023

ESMO Open

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“…The causal effect of body adiposity on the CRF cannot be confirmed in the present study, yet the result is alarming considering that obesity and abdominal visceral adipose tissue accumulation are associated with metabolic consequences and risk of cardiovascular disease (CVD), the latter being the leading cause of death in postmenopausal women [ 82 ] and also in BC survivors [ 83 ]. Furthermore, antineoplastic treatment, including endocrine therapy, may favor cardiotoxicity [ 84 ]. Mazzutti and colleagues [ 30 ] identified in the same sample of the present study, that women in AI use had a significant number of risk factors for CVD.…”

Section: Discussionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy

et al. 2022

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Background The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. Methods This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. Results At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (β = -2.279, p = 0.045) and muscle/joint aches (β = -0.779, p = 0.013) were significant with CRF only at baseline. Conclusions This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy.

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Cardiovascular Disease Risk in Survivors of Breast Cancer

Cited by 8 publications

References 93 publications

Breast Cancer Survivors Undergoing Endocrine Therapy Have a Worrying Risk Factor Profile for Cardiovascular Diseases

Breast Cancer Survivors Undergoing Endocrine Therapy Have a Worrying Risk Factor Profile for Cardiovascular Diseases

Cardiac safety of dual anti-HER2 blockade with pertuzumab plus trastuzumab in early HER2-positive breast cancer in the APHINITY trial

Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy

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