Racial disparities in major cardiovascular and cerebrovascular adverse events in breast cancer survivors: A nationwide analysis

Abstract

Background: Improved survival outcomes in breast cancer has brought attention to major cardiovascular and cerebrovascular adverse events (MACCE). Racial disparities in these events among breast cancer survivors are understudied. Methods: Using National Inpatient Sample datasets (October 2015-December 2017, ICD-10-CM), we investigated racial disparities in the hospitalized breast cancer survivors for MACCE. They were further sub-categorized on the basis of prior chemotherapy or radiation therapy (CT/RT). Results: Of 1,301,320 breast cancer survivor women, 75.8% were White, 11.3% were Black, and 16.1% had prior CT/RT. All-cause in-hospital mortality was highest in Asian or Pacific Islanders (3.2%) in the whole breast cancer survivor population; and in Native Americans (4.7%) in CT/RT subgroup. Native Americans (4.1%) had the highest incidence of acute myocardial infarction (AMI) in the overall population, whereas White patients (2.9%) predominated in CT/RT subgroup. White patients (29.6%) had the highest prevalence of arrhythmia, regardless of the prior CT/RT. For strokes, Asian or Pacific Islanders (3.9%) and Black patients (3.8%) had a higher prevalence. All-cause mortality, AMI, arrhythmia, and stroke had the highest adjusted odds in Asian or Pacific Islanders (1.19), Native Americans (1.31), White patients (1), and Black patients (1.12) respectively. Black patients had the lowest quartile income and a longer median stay. White patients had the highest transfer to nursing facilities, whereas Asian or Pacific Islanders had the highest mean hospital expenditures. Conclusions: Racial disparities exist in MACCE among breast cancer survivors. Further research, especially pooling and analyzing real-world data is needed on the prevalence of MACCE in breast cancer survivors, particularly in subgroups with different cancer-related treatments.

Impact of amyloidosis on the outcomes of percutaneous coronary intervention recipients: a nationwide analysis

“…19,20 In patients with cancer and amyloidosis, there could be racial differences in the cardiovascular outcomes as well. 21 Amyloidosis was also associated with a higher incidence of complications of surgical care/injury (odds ratio 2.05, p<0.001). Considering the higher incidence of hypertension, diabetes, and obesity in this patient group, it is expected to observe a greater occurrence of surgical complications, in-hospital mortality, and major loss of function.…”

Impact of amyloidosis on the outcomes of patients with coronary artery disease: A nationwide analysis

“…30 Sometimes, the incidence of AF varies in different races for cancer patients. 31 It has not been established whether the presence of CAD in CA could further augment the degree of AF complications such as embolic stroke and acute heart failure, which prompts the need for further investigation.…”