A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support
Abstract Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and non-ischemic cardiomyopathy (NIC) cohorts req...
Gespeichert in:
| Veröffentlicht in: | The American journal of cardiology 2016-11, Vol.118 (10), p.1539-1544 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1544 |
|---|---|
| container_issue | 10 |
| container_start_page | 1539 |
| container_title | The American journal of cardiology |
| container_volume | 118 |
| creator | Thomas, Garry R., MD, MSc McDonald, Michael A., MD Day, Jennifer, RDCS Ross, Heather J., MD, MHSc Delgado, Diego H., MD, MSc Billia, Filio, MD, PhD Butany, Jagdish W., MD Rao, Vivek, MD, PhD Amir, Eitan, MD, PhD Bedard, Philippe L., MD Thavendiranathan, Paaladinesh, MD, MSc, SM |
| description | Abstract Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and non-ischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiography parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study. All patients who received a ventricular assist device (VAD) or OHT at a large Canadian center were reviewed (N=421; 1988-2015) and individuals with clinical and pathological evidence of AIC were included (N=17, 4.0%). A comparison cohort with idiopathic NIC from the same database, matched 3:1 for age, sex, ethnicity, and year of heart failure onset was selected. The Mann-Whitney Rank Sum and Fisher's Exact tests were used for comparisons. AIC patients were predominantly female (70.6%) with heart failure diagnosed at age 40.2±15.8 years and 8.3±8.9 years following anthracycline treatment. When compared to NIC, no differences were seen in co-morbidities, echocardiographic measures, the proportion of patients receiving a defibrillator, VAD, or OHT, the incidence of graft failure, and all-cause mortality. In contrast to other studies, AIC was not associated with a higher incidence of right ventricular dysfunction. A greater proportion of AIC patients developed cancer (recurrence or new primary) post-OHT (21.4% vs. 2.3%, p=0.042). In conclusion, we demonstrate that when matched cohorts of patients with end-stage heart failure secondary to AIC and idiopathic NIC are compared, they are similar with respect to co-morbidities, degree of ventricular dysfunction, and advanced therapeutics employed. The prognosis with OHT is also similar. |
| doi_str_mv | 10.1016/j.amjcard.2016.08.020 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1846411053</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002914916313807</els_id><sourcerecordid>1846411053</sourcerecordid><originalsourceid>FETCH-LOGICAL-c551t-87e2f8a3a3cb00180f10ded7360d6eecf70af088685214584844d084ac7be8013</originalsourceid><addsrcrecordid>eNqFks9u1DAQxiMEokvhEUCWuHBJGMeJ472AVquWVioCsXC2vPak6yWJt7ZTlHfgoXG0S5F64TQa6Tff_Pkmy15TKChQ_n5fqH6vlTdFmdICRAElPMkWVDTLnC4pe5otAKDMl7RanmUvQtinlNKaP8_OyoazJRd8kf1ekc8q6h0asnY75yPZxNFMxLXkq4oWhxjILxt35GIweYjqFskVqoRdKtuNHknrXU9WQ9x5pSfd2QHz68GMehZM01nXT-6g4m4i3_ButN4Ot2Rl7tXwQChNNuPhkHq_zJ61qgv46hTPsx-XF9_XV_nNl0_X69VNruuaxlw0WLZCMcX0Nq0koKVg0DSMg-GIum1AtSAEF3VJq1pUoqoMiErpZosCKDvP3h11D97djRii7G3Q2HVqQDcGSUXFK0qhZgl9-wjdu9EPabpEsaYWvIQyUfWR0t6F4LGVB2975SdJQc52yb082SVnuyQImexKdW9O6uO2R_NQ9defBHw8ApjOcW_Ry6CTKel21qOO0jj73xYfHinMJlmtup84Yfi3jQylBLmZf2Z-GcoZZQIa9gdWQL36</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837586202</pqid></control><display><type>article</type><title>A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Thomas, Garry R., MD, MSc ; McDonald, Michael A., MD ; Day, Jennifer, RDCS ; Ross, Heather J., MD, MHSc ; Delgado, Diego H., MD, MSc ; Billia, Filio, MD, PhD ; Butany, Jagdish W., MD ; Rao, Vivek, MD, PhD ; Amir, Eitan, MD, PhD ; Bedard, Philippe L., MD ; Thavendiranathan, Paaladinesh, MD, MSc, SM</creator><creatorcontrib>Thomas, Garry R., MD, MSc ; McDonald, Michael A., MD ; Day, Jennifer, RDCS ; Ross, Heather J., MD, MHSc ; Delgado, Diego H., MD, MSc ; Billia, Filio, MD, PhD ; Butany, Jagdish W., MD ; Rao, Vivek, MD, PhD ; Amir, Eitan, MD, PhD ; Bedard, Philippe L., MD ; Thavendiranathan, Paaladinesh, MD, MSc, SM</creatorcontrib><description>Abstract Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and non-ischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiography parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study. All patients who received a ventricular assist device (VAD) or OHT at a large Canadian center were reviewed (N=421; 1988-2015) and individuals with clinical and pathological evidence of AIC were included (N=17, 4.0%). A comparison cohort with idiopathic NIC from the same database, matched 3:1 for age, sex, ethnicity, and year of heart failure onset was selected. The Mann-Whitney Rank Sum and Fisher's Exact tests were used for comparisons. AIC patients were predominantly female (70.6%) with heart failure diagnosed at age 40.2±15.8 years and 8.3±8.9 years following anthracycline treatment. When compared to NIC, no differences were seen in co-morbidities, echocardiographic measures, the proportion of patients receiving a defibrillator, VAD, or OHT, the incidence of graft failure, and all-cause mortality. In contrast to other studies, AIC was not associated with a higher incidence of right ventricular dysfunction. A greater proportion of AIC patients developed cancer (recurrence or new primary) post-OHT (21.4% vs. 2.3%, p=0.042). In conclusion, we demonstrate that when matched cohorts of patients with end-stage heart failure secondary to AIC and idiopathic NIC are compared, they are similar with respect to co-morbidities, degree of ventricular dysfunction, and advanced therapeutics employed. The prognosis with OHT is also similar.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2016.08.020</identifier><identifier>PMID: 27639686</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age ; Anthracyclines - adverse effects ; Anthracyclines - therapeutic use ; Cancer ; Cancer therapies ; Cardiomyopathies - chemically induced ; Cardiomyopathies - complications ; Cardiomyopathies - diagnosis ; Cardiomyopathy ; Cardiovascular ; Female ; Follow-Up Studies ; Heart failure ; Heart Failure - epidemiology ; Heart Failure - etiology ; Heart Failure - therapy ; Heart-Assist Devices ; Humans ; Incidence ; Kidney diseases ; Male ; Medical prognosis ; Microscopy ; Neoplasms - complications ; Neoplasms - drug therapy ; Ontario - epidemiology ; Patients ; Registries ; Retrospective Studies ; Studies ; Survival Rate ; Time Factors</subject><ispartof>The American journal of cardiology, 2016-11, Vol.118 (10), p.1539-1544</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 15, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c551t-87e2f8a3a3cb00180f10ded7360d6eecf70af088685214584844d084ac7be8013</citedby><cites>FETCH-LOGICAL-c551t-87e2f8a3a3cb00180f10ded7360d6eecf70af088685214584844d084ac7be8013</cites><orcidid>0000-0001-5746-8016</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1837586202?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,46004,64394,64396,64398,72478</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27639686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thomas, Garry R., MD, MSc</creatorcontrib><creatorcontrib>McDonald, Michael A., MD</creatorcontrib><creatorcontrib>Day, Jennifer, RDCS</creatorcontrib><creatorcontrib>Ross, Heather J., MD, MHSc</creatorcontrib><creatorcontrib>Delgado, Diego H., MD, MSc</creatorcontrib><creatorcontrib>Billia, Filio, MD, PhD</creatorcontrib><creatorcontrib>Butany, Jagdish W., MD</creatorcontrib><creatorcontrib>Rao, Vivek, MD, PhD</creatorcontrib><creatorcontrib>Amir, Eitan, MD, PhD</creatorcontrib><creatorcontrib>Bedard, Philippe L., MD</creatorcontrib><creatorcontrib>Thavendiranathan, Paaladinesh, MD, MSc, SM</creatorcontrib><title>A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Abstract Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and non-ischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiography parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study. All patients who received a ventricular assist device (VAD) or OHT at a large Canadian center were reviewed (N=421; 1988-2015) and individuals with clinical and pathological evidence of AIC were included (N=17, 4.0%). A comparison cohort with idiopathic NIC from the same database, matched 3:1 for age, sex, ethnicity, and year of heart failure onset was selected. The Mann-Whitney Rank Sum and Fisher's Exact tests were used for comparisons. AIC patients were predominantly female (70.6%) with heart failure diagnosed at age 40.2±15.8 years and 8.3±8.9 years following anthracycline treatment. When compared to NIC, no differences were seen in co-morbidities, echocardiographic measures, the proportion of patients receiving a defibrillator, VAD, or OHT, the incidence of graft failure, and all-cause mortality. In contrast to other studies, AIC was not associated with a higher incidence of right ventricular dysfunction. A greater proportion of AIC patients developed cancer (recurrence or new primary) post-OHT (21.4% vs. 2.3%, p=0.042). In conclusion, we demonstrate that when matched cohorts of patients with end-stage heart failure secondary to AIC and idiopathic NIC are compared, they are similar with respect to co-morbidities, degree of ventricular dysfunction, and advanced therapeutics employed. The prognosis with OHT is also similar.</description><subject>Adult</subject><subject>Age</subject><subject>Anthracyclines - adverse effects</subject><subject>Anthracyclines - therapeutic use</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Cardiomyopathies - chemically induced</subject><subject>Cardiomyopathies - complications</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart failure</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - therapy</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Microscopy</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - drug therapy</subject><subject>Ontario - epidemiology</subject><subject>Patients</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks9u1DAQxiMEokvhEUCWuHBJGMeJ472AVquWVioCsXC2vPak6yWJt7ZTlHfgoXG0S5F64TQa6Tff_Pkmy15TKChQ_n5fqH6vlTdFmdICRAElPMkWVDTLnC4pe5otAKDMl7RanmUvQtinlNKaP8_OyoazJRd8kf1ekc8q6h0asnY75yPZxNFMxLXkq4oWhxjILxt35GIweYjqFskVqoRdKtuNHknrXU9WQ9x5pSfd2QHz68GMehZM01nXT-6g4m4i3_ButN4Ot2Rl7tXwQChNNuPhkHq_zJ61qgv46hTPsx-XF9_XV_nNl0_X69VNruuaxlw0WLZCMcX0Nq0koKVg0DSMg-GIum1AtSAEF3VJq1pUoqoMiErpZosCKDvP3h11D97djRii7G3Q2HVqQDcGSUXFK0qhZgl9-wjdu9EPabpEsaYWvIQyUfWR0t6F4LGVB2975SdJQc52yb082SVnuyQImexKdW9O6uO2R_NQ9defBHw8ApjOcW_Ry6CTKel21qOO0jj73xYfHinMJlmtup84Yfi3jQylBLmZf2Z-GcoZZQIa9gdWQL36</recordid><startdate>20161115</startdate><enddate>20161115</enddate><creator>Thomas, Garry R., MD, MSc</creator><creator>McDonald, Michael A., MD</creator><creator>Day, Jennifer, RDCS</creator><creator>Ross, Heather J., MD, MHSc</creator><creator>Delgado, Diego H., MD, MSc</creator><creator>Billia, Filio, MD, PhD</creator><creator>Butany, Jagdish W., MD</creator><creator>Rao, Vivek, MD, PhD</creator><creator>Amir, Eitan, MD, PhD</creator><creator>Bedard, Philippe L., MD</creator><creator>Thavendiranathan, Paaladinesh, MD, MSc, SM</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QO</scope><orcidid>https://orcid.org/0000-0001-5746-8016</orcidid></search><sort><creationdate>20161115</creationdate><title>A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support</title><author>Thomas, Garry R., MD, MSc ; McDonald, Michael A., MD ; Day, Jennifer, RDCS ; Ross, Heather J., MD, MHSc ; Delgado, Diego H., MD, MSc ; Billia, Filio, MD, PhD ; Butany, Jagdish W., MD ; Rao, Vivek, MD, PhD ; Amir, Eitan, MD, PhD ; Bedard, Philippe L., MD ; Thavendiranathan, Paaladinesh, MD, MSc, SM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c551t-87e2f8a3a3cb00180f10ded7360d6eecf70af088685214584844d084ac7be8013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age</topic><topic>Anthracyclines - adverse effects</topic><topic>Anthracyclines - therapeutic use</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Cardiomyopathies - chemically induced</topic><topic>Cardiomyopathies - complications</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart failure</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - therapy</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney diseases</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Microscopy</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - drug therapy</topic><topic>Ontario - epidemiology</topic><topic>Patients</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Studies</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Garry R., MD, MSc</creatorcontrib><creatorcontrib>McDonald, Michael A., MD</creatorcontrib><creatorcontrib>Day, Jennifer, RDCS</creatorcontrib><creatorcontrib>Ross, Heather J., MD, MHSc</creatorcontrib><creatorcontrib>Delgado, Diego H., MD, MSc</creatorcontrib><creatorcontrib>Billia, Filio, MD, PhD</creatorcontrib><creatorcontrib>Butany, Jagdish W., MD</creatorcontrib><creatorcontrib>Rao, Vivek, MD, PhD</creatorcontrib><creatorcontrib>Amir, Eitan, MD, PhD</creatorcontrib><creatorcontrib>Bedard, Philippe L., MD</creatorcontrib><creatorcontrib>Thavendiranathan, Paaladinesh, MD, MSc, SM</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Biotechnology Research Abstracts</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Garry R., MD, MSc</au><au>McDonald, Michael A., MD</au><au>Day, Jennifer, RDCS</au><au>Ross, Heather J., MD, MHSc</au><au>Delgado, Diego H., MD, MSc</au><au>Billia, Filio, MD, PhD</au><au>Butany, Jagdish W., MD</au><au>Rao, Vivek, MD, PhD</au><au>Amir, Eitan, MD, PhD</au><au>Bedard, Philippe L., MD</au><au>Thavendiranathan, Paaladinesh, MD, MSc, SM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2016-11-15</date><risdate>2016</risdate><volume>118</volume><issue>10</issue><spage>1539</spage><epage>1544</epage><pages>1539-1544</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Abstract Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and non-ischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiography parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study. All patients who received a ventricular assist device (VAD) or OHT at a large Canadian center were reviewed (N=421; 1988-2015) and individuals with clinical and pathological evidence of AIC were included (N=17, 4.0%). A comparison cohort with idiopathic NIC from the same database, matched 3:1 for age, sex, ethnicity, and year of heart failure onset was selected. The Mann-Whitney Rank Sum and Fisher's Exact tests were used for comparisons. AIC patients were predominantly female (70.6%) with heart failure diagnosed at age 40.2±15.8 years and 8.3±8.9 years following anthracycline treatment. When compared to NIC, no differences were seen in co-morbidities, echocardiographic measures, the proportion of patients receiving a defibrillator, VAD, or OHT, the incidence of graft failure, and all-cause mortality. In contrast to other studies, AIC was not associated with a higher incidence of right ventricular dysfunction. A greater proportion of AIC patients developed cancer (recurrence or new primary) post-OHT (21.4% vs. 2.3%, p=0.042). In conclusion, we demonstrate that when matched cohorts of patients with end-stage heart failure secondary to AIC and idiopathic NIC are compared, they are similar with respect to co-morbidities, degree of ventricular dysfunction, and advanced therapeutics employed. The prognosis with OHT is also similar.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27639686</pmid><doi>10.1016/j.amjcard.2016.08.020</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5746-8016</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2016-11, Vol.118 (10), p.1539-1544 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1846411053 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Adult Age Anthracyclines - adverse effects Anthracyclines - therapeutic use Cancer Cancer therapies Cardiomyopathies - chemically induced Cardiomyopathies - complications Cardiomyopathies - diagnosis Cardiomyopathy Cardiovascular Female Follow-Up Studies Heart failure Heart Failure - epidemiology Heart Failure - etiology Heart Failure - therapy Heart-Assist Devices Humans Incidence Kidney diseases Male Medical prognosis Microscopy Neoplasms - complications Neoplasms - drug therapy Ontario - epidemiology Patients Registries Retrospective Studies Studies Survival Rate Time Factors |
| title | A Matched Cohort Study of Patients with End-stage Heart Failure from Anthracycline-Induced Cardiomyopathy Requiring Advanced Cardiac Support |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-03T12%3A49%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Matched%20Cohort%20Study%20of%20Patients%20with%20End-stage%20Heart%20Failure%20from%20Anthracycline-Induced%20Cardiomyopathy%20Requiring%20Advanced%20Cardiac%20Support&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Thomas,%20Garry%20R.,%20MD,%20MSc&rft.date=2016-11-15&rft.volume=118&rft.issue=10&rft.spage=1539&rft.epage=1544&rft.pages=1539-1544&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/j.amjcard.2016.08.020&rft_dat=%3Cproquest_cross%3E1846411053%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1837586202&rft_id=info:pmid/27639686&rft_els_id=1_s2_0_S0002914916313807&rfr_iscdi=true |