Long‐term risk of congestive heart failure in younger breast cancer survivors: A nationwide study by the SMARTSHIP group

Lee, Jihyoun; Hur, Ho; Lee, Jong Won; Youn, Hyun Jo; Han, Kyungdo; Kim, Nam Won; Jung, So‐Youn; Kim, Zisun; Kim, Ku Sang; Lee, Min Hyuk; Han, Sehwan; Jung, Sung Hoo; Chung, Il Yong

doi:10.1002/cncr.32485

Cited by 28 publications

(31 citation statements)

References 20 publications

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“…MI was determined as the recording of ICD-10 codes I21 or I22 during hospitalization or ≥ two claims under those codes, according to previous reports [19, 21]. Hospitalization for HF was defined as ≥ one hospitalization under a primary diagnosis of ICD-10 code I50 [22, 23]. Following previous reports [24–26], AF was defined as the recording of ICD-10 codes I480–I484 or I489 during hospitalization or these codes having been recorded at least twice.…”

Section: Methodsmentioning

confidence: 99%

Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

Lee

Han

Kim

et al. 2019

Cardiovasc Diabetol

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BackgroundBoth type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes.MethodsWe used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline.ResultsDuring more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490–1.893) for MI; 2.105 (1.901–2.330) for HF; 1.608 (1.411–1.833) for AF; 1.884 (1.762–2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138–2.718) for MI; 3.024 (2.730–3.350) for HF; 1.748 (1.534–1.993) for AF; 2.874 (2.689–3.073) for death].ConclusionsIn Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes.

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Section: Methodsmentioning

confidence: 99%

Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

Lee

Han

Kim

et al. 2019

Cardiovasc Diabetol

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“…The endpoint was incidence of hHF. The hHF was defined as the first hospitalization under a primary diagnosis of ICD-10 code I50 as reported in previous studies [23][24][25]. The study population was followed up from baseline (the date of the second health examination between 2013 and 2014) until the date of death, development of hHF, or December 31, 2017, whichever came first.…”

Section: Study Cohort Outcomes and Follow-upmentioning

confidence: 99%

Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study

Lee

Kim

et al. 2020

Cardiovasc Diabetol

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Background: We aimed to investigate the hazard of hospitalization for heart failure (hHF) according to the transitions in metabolic health and obesity status. Methods: The Korean National Health Insurance Service datasets from 2002 to 2017 were used for this nationwide, longitudinal, population-based study. The hazard of hHF was analyzed according to the eight groups stratified by stability in metabolic health and transition in obesity status among initially metabolically healthy adults who underwent two cycles of health examinations in 2009-2010 and 2013-2014 (N = 7,148,763). Results: During two examinations, 48.43% of the initially metabolically healthy obese (MHO) individuals and 20.94% of the initially metabolically healthy non-obese (MHNO) individuals showed changes in their metabolic health and obesity status. During a mean follow-up of 3.70 years, 3151 individuals were hospitalized for HF. When stable MHNO individuals were set as the reference, transition to metabolically unhealthy phenotype was associated with an increased hazard of hHF; the hazard ratio (HR) and 95% confidence interval (CI) in the individuals who transformed from MHO to metabolically unhealthy non-obese was 2.033 (1.579-2.616). The constant MHO group had a 17.3% increased hazard of hHF compared with the stable MHNO group [HR (95% CI) 1.173 (1.039-1.325)]. Individuals who shifted from MHO to MHNO showed a 34.3% lower hazard of hHF compared with those who maintained the MHO category [HR (95% CI) 0.657 (0.508-0.849)]. Conclusion: Dynamic changes in metabolic health and obesity status were observed during a relatively short interval of 3-5 years. Loss of metabolic health was significantly associated with an increased hazard of hHF. Even if metabolic health was maintained, persistent obesity remained as a risk factor for hHF, and transition from MHO to MHNO had a protective effect against hHF. Therefore, the prevention and control of obesity while maintaining metabolic health would be crucial in preventing hHF.

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“…CHF was defined as three or more claims with the ICD-10 codes of heart failure (heart failure, I50; hypertensive heart disease with heart failure, I110) [ 15 , 14 ]. Physicians can enter the ICD-10 codes just to rule out CHF.…”

Section: Methodsmentioning

confidence: 99%

“…For landmark analysis, the index date was defined as the date 2 years after breast cancer diagnosis. Late-onset CHF was defined as CHF which developed after 2 years following breast cancer diagnosis [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of standard low-dose anthracycline chemotherapy on late congestive heart failure in breast cancer survivors aged between 50 and 59 at diagnosis: A nationwide study

et al. 2020

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Objectives Although chemotherapy-induced congestive heart failure (CHF) is a well-known adverse event in cancer survivors, the long-term risk of standard low-dose anthracycline has not yet been reported. This study aimed to investigate the long-term effects of standard anthracycline on late CHF in breast cancer survivors. Materials and methods A nationwide retrospective cohort study was conducted using the national insurance claims data for nearly 98% of Korean citizens. Between Jan 2010 and Dec 2015, a total of 56,338 newly diagnosed female breast cancer survivors were included. Results The total number of person-years was 199,648 and the incidence rate of late CHF was 3.57 per 1000 person-years. In multivariate analysis according to the subject’s age at diagnosis, only in the 50–59 age group, anthracycline-based [hazard ratio (HR) 1.765, 95% confidence interval (CI) 1.206–2.583] and taxane plus anthracycline-based regimens (HR 1.816, 95% CI 1.192–2.768) significantly increased the risk of late CHF. In the 50–59 age group, standard low-dose anthracycline significantly increased the risk of late CHF (HR 1.627, 95% CI 1.080–2.451) in Cox proportional hazard regression models. In competing risk model with recurrence and in-hospital death as competing risks, standard low-dose anthracycline was a significant risk factor for late CHF [subdistribution hazard ratio (SHR) 1.553, 95% CI 1.029–2.340]. Conclusion This nationwide study showed that standard chemotherapy with low-dose anthracycline is a risk factor for late-onset CHF in breast cancer survivors who were in their 50 s at breast cancer diagnosis. Long-term monitoring of late CHF should be considered in these younger breast cancer survivors.

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Long‐term risk of congestive heart failure in younger breast cancer survivors: A nationwide study by the SMARTSHIP group

Cited by 28 publications

References 20 publications

Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study

Effect of standard low-dose anthracycline chemotherapy on late congestive heart failure in breast cancer survivors aged between 50 and 59 at diagnosis: A nationwide study

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