Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database
Purpose We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea. Methods We included female patients > 19 years old from the H...
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| Veröffentlicht in: | Breast cancer research and treatment 2018-08, Vol.171 (1), p.181-188 |
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| creator | Choi, Jung Yoon Cho, Eun Young Choi, Yoon Ji Lee, Jeong Hyeon Jung, Seung Pil Cho, Kyu Ran Kim, Chul Yong Kim, Yeul Hong Park, Kyong Hwa |
| description | Purpose
We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea.
Methods
We included female patients > 19 years old from the Health Insurance Review and Assessment Service database who had no prior CHF history and had been diagnosed with early breast cancer between January 2007 and October 2016.
Results
We included 83,544 patients in our analysis. In terms of crude incidence for CHF, AC followed by T showed the highest incidence (6.3%). However, 3.1 and 4.2% of the patients had CHF due to AC-based chemotherapy and non-AC followed by T, respectively. The median times to occurrence of CHF were different according to adjuvant treatments, approximately 2 years (701.0 days) in the AC-based chemotherapy group vs 1 year (377.5 days) AC followed by T group. T therapy was associated with earlier development of CHF irrespective of previous chemotherapy, but late risk of CHF 1.2 years after T therapy rapidly decreased in both chemotherapy groups. Multivariate Cox regression analysis revealed that the adjusted hazard ratio for CHF was increased in the group of older patients (≥ 65 years old) who underwent AC followed by T therapy, with Charlson comorbidity index scores of ≥ 2.
Conclusions
Our study showed that neo-/adjuvant chemotherapy using T irrespective of previous chemotherapy (AC or non-AC) was associated with significantly increased risk of CHF compared with AC-based chemotherapy in Korean patients with early breast cancer. |
| doi_str_mv | 10.1007/s10549-018-4809-8 |
| format | Article |
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We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea.
Methods
We included female patients > 19 years old from the Health Insurance Review and Assessment Service database who had no prior CHF history and had been diagnosed with early breast cancer between January 2007 and October 2016.
Results
We included 83,544 patients in our analysis. In terms of crude incidence for CHF, AC followed by T showed the highest incidence (6.3%). However, 3.1 and 4.2% of the patients had CHF due to AC-based chemotherapy and non-AC followed by T, respectively. The median times to occurrence of CHF were different according to adjuvant treatments, approximately 2 years (701.0 days) in the AC-based chemotherapy group vs 1 year (377.5 days) AC followed by T group. T therapy was associated with earlier development of CHF irrespective of previous chemotherapy, but late risk of CHF 1.2 years after T therapy rapidly decreased in both chemotherapy groups. Multivariate Cox regression analysis revealed that the adjusted hazard ratio for CHF was increased in the group of older patients (≥ 65 years old) who underwent AC followed by T therapy, with Charlson comorbidity index scores of ≥ 2.
Conclusions
Our study showed that neo-/adjuvant chemotherapy using T irrespective of previous chemotherapy (AC or non-AC) was associated with significantly increased risk of CHF compared with AC-based chemotherapy in Korean patients with early breast cancer.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-018-4809-8</identifier><identifier>PMID: 29737474</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant chemotherapy ; Adult ; Aged ; Aged, 80 and over ; Anthracycline ; Anthracyclines ; Anthracyclines - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Big Data ; Breast cancer ; Breast Neoplasms - complications ; Breast Neoplasms - drug therapy ; Breast Neoplasms - epidemiology ; Breast Neoplasms - pathology ; Cancer patients ; Cancer research ; Cancer therapies ; Cardiac patients ; Chemotherapy ; Comorbidity ; Congestive heart failure ; Databases, Factual ; Development and progression ; Epidemiology ; Female ; Heart failure ; Heart Failure - epidemiology ; Heart Failure - etiology ; Humans ; Immunotherapy ; Incidence ; Medicine ; Medicine & Public Health ; Middle Aged ; Monoclonal antibodies ; Oncology ; Proportional Hazards Models ; Public Health Surveillance ; Risk Assessment ; Risk Factors ; Targeted cancer therapy ; Trastuzumab ; Trastuzumab - administration & dosage</subject><ispartof>Breast cancer research and treatment, 2018-08, Vol.171 (1), p.181-188</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Breast Cancer Research and Treatment is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-ecce0a19b716a70a1d3f02ebeb3846fb8a11bf933514c032b9555d429c0dc0353</citedby><cites>FETCH-LOGICAL-c470t-ecce0a19b716a70a1d3f02ebeb3846fb8a11bf933514c032b9555d429c0dc0353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-018-4809-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-018-4809-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29737474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Jung Yoon</creatorcontrib><creatorcontrib>Cho, Eun Young</creatorcontrib><creatorcontrib>Choi, Yoon Ji</creatorcontrib><creatorcontrib>Lee, Jeong Hyeon</creatorcontrib><creatorcontrib>Jung, Seung Pil</creatorcontrib><creatorcontrib>Cho, Kyu Ran</creatorcontrib><creatorcontrib>Kim, Chul Yong</creatorcontrib><creatorcontrib>Kim, Yeul Hong</creatorcontrib><creatorcontrib>Park, Kyong Hwa</creatorcontrib><title>Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea.
Methods
We included female patients > 19 years old from the Health Insurance Review and Assessment Service database who had no prior CHF history and had been diagnosed with early breast cancer between January 2007 and October 2016.
Results
We included 83,544 patients in our analysis. In terms of crude incidence for CHF, AC followed by T showed the highest incidence (6.3%). However, 3.1 and 4.2% of the patients had CHF due to AC-based chemotherapy and non-AC followed by T, respectively. The median times to occurrence of CHF were different according to adjuvant treatments, approximately 2 years (701.0 days) in the AC-based chemotherapy group vs 1 year (377.5 days) AC followed by T group. T therapy was associated with earlier development of CHF irrespective of previous chemotherapy, but late risk of CHF 1.2 years after T therapy rapidly decreased in both chemotherapy groups. Multivariate Cox regression analysis revealed that the adjusted hazard ratio for CHF was increased in the group of older patients (≥ 65 years old) who underwent AC followed by T therapy, with Charlson comorbidity index scores of ≥ 2.
Conclusions
Our study showed that neo-/adjuvant chemotherapy using T irrespective of previous chemotherapy (AC or non-AC) was associated with significantly increased risk of CHF compared with AC-based chemotherapy in Korean patients with early breast cancer.</description><subject>Adjuvant chemotherapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anthracycline</subject><subject>Anthracyclines</subject><subject>Anthracyclines - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Big Data</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Cardiac patients</subject><subject>Chemotherapy</subject><subject>Comorbidity</subject><subject>Congestive heart failure</subject><subject>Databases, Factual</subject><subject>Development and progression</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - etiology</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Incidence</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Oncology</subject><subject>Proportional Hazards Models</subject><subject>Public Health Surveillance</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Targeted cancer therapy</subject><subject>Trastuzumab</subject><subject>Trastuzumab - administration & dosage</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1ks9u1DAQxiMEokvhAbggS0iIS1o7_5xwW1VAV1RCQnC2HGeycUnsxeNstbwv78HsbqEUgXyInfnNN57xlyTPBT8TnMtzFLwsmpSLOi1q3qT1g2QhSpmnMhPyYbLgopJpVfPqJHmCeM05byRvHicnWSNzWchikfxYOWM7cAaYdh0LFr-yXpvoA7LeB2a8WwNGuwU2gA6RgnacAzDr2EZHCy4iu7FxYBQdd6wNoDEyo0kxsJvBswAGKL0j_TgEbXZmtO5Q7Zz0YyB8_j5Pun3DNGvtmnU6agrrcYcWme9ZHIB98CTs2CXokWqtHM5hX4J9gq2Fm8Pdl4iAONGNGELYWorupVqN8DR51OsR4dnt9zT58u7t54vL9Orj-9XF8io1heQxBWOAa9G0UlRa0q7Le55BC21eF1Xf1lqItm_yvBSF4XnWNmVZdkXWGN7RucxPk9dH3U3w32aam5osGhhH7cDPqDKeVxm9nOSEvvwLvfZzoK4PVNkUucyaO2qtR1DW9Z4GZvaialkWVSlkUQuizv5B0epgsvSC0Fv6fy_h1R8Jw2Go6Mc5Wu_wPiiOoAkeMUCvNsFOOuyU4GrvQXX0oCIPqr0HVU05L247m9sJut8Zv0xHQHYEkEJkr3DX-v9VfwI3t-mO</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Choi, Jung Yoon</creator><creator>Cho, Eun Young</creator><creator>Choi, Yoon Ji</creator><creator>Lee, Jeong Hyeon</creator><creator>Jung, Seung Pil</creator><creator>Cho, Kyu Ran</creator><creator>Kim, Chul Yong</creator><creator>Kim, Yeul Hong</creator><creator>Park, Kyong Hwa</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</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>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</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>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20180801</creationdate><title>Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database</title><author>Choi, Jung Yoon ; Cho, Eun Young ; Choi, Yoon Ji ; Lee, Jeong Hyeon ; Jung, Seung Pil ; Cho, Kyu Ran ; Kim, Chul Yong ; Kim, Yeul Hong ; Park, Kyong Hwa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-ecce0a19b716a70a1d3f02ebeb3846fb8a11bf933514c032b9555d429c0dc0353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adjuvant chemotherapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anthracycline</topic><topic>Anthracyclines</topic><topic>Anthracyclines - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Big Data</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Cardiac patients</topic><topic>Chemotherapy</topic><topic>Comorbidity</topic><topic>Congestive heart failure</topic><topic>Databases, Factual</topic><topic>Development and progression</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - etiology</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Incidence</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Oncology</topic><topic>Proportional Hazards Models</topic><topic>Public Health Surveillance</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Targeted cancer therapy</topic><topic>Trastuzumab</topic><topic>Trastuzumab - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Jung Yoon</creatorcontrib><creatorcontrib>Cho, Eun Young</creatorcontrib><creatorcontrib>Choi, Yoon Ji</creatorcontrib><creatorcontrib>Lee, Jeong Hyeon</creatorcontrib><creatorcontrib>Jung, Seung Pil</creatorcontrib><creatorcontrib>Cho, Kyu Ran</creatorcontrib><creatorcontrib>Kim, Chul Yong</creatorcontrib><creatorcontrib>Kim, Yeul Hong</creatorcontrib><creatorcontrib>Park, Kyong Hwa</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>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health 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>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</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 Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Jung Yoon</au><au>Cho, Eun Young</au><au>Choi, Yoon Ji</au><au>Lee, Jeong Hyeon</au><au>Jung, Seung Pil</au><au>Cho, Kyu Ran</au><au>Kim, Chul Yong</au><au>Kim, Yeul Hong</au><au>Park, Kyong Hwa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>171</volume><issue>1</issue><spage>181</spage><epage>188</epage><pages>181-188</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea.
Methods
We included female patients > 19 years old from the Health Insurance Review and Assessment Service database who had no prior CHF history and had been diagnosed with early breast cancer between January 2007 and October 2016.
Results
We included 83,544 patients in our analysis. In terms of crude incidence for CHF, AC followed by T showed the highest incidence (6.3%). However, 3.1 and 4.2% of the patients had CHF due to AC-based chemotherapy and non-AC followed by T, respectively. The median times to occurrence of CHF were different according to adjuvant treatments, approximately 2 years (701.0 days) in the AC-based chemotherapy group vs 1 year (377.5 days) AC followed by T group. T therapy was associated with earlier development of CHF irrespective of previous chemotherapy, but late risk of CHF 1.2 years after T therapy rapidly decreased in both chemotherapy groups. Multivariate Cox regression analysis revealed that the adjusted hazard ratio for CHF was increased in the group of older patients (≥ 65 years old) who underwent AC followed by T therapy, with Charlson comorbidity index scores of ≥ 2.
Conclusions
Our study showed that neo-/adjuvant chemotherapy using T irrespective of previous chemotherapy (AC or non-AC) was associated with significantly increased risk of CHF compared with AC-based chemotherapy in Korean patients with early breast cancer.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29737474</pmid><doi>10.1007/s10549-018-4809-8</doi><tpages>8</tpages></addata></record> |
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| ispartof | Breast cancer research and treatment, 2018-08, Vol.171 (1), p.181-188 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adjuvant chemotherapy Adult Aged Aged, 80 and over Anthracycline Anthracyclines Anthracyclines - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Big Data Breast cancer Breast Neoplasms - complications Breast Neoplasms - drug therapy Breast Neoplasms - epidemiology Breast Neoplasms - pathology Cancer patients Cancer research Cancer therapies Cardiac patients Chemotherapy Comorbidity Congestive heart failure Databases, Factual Development and progression Epidemiology Female Heart failure Heart Failure - epidemiology Heart Failure - etiology Humans Immunotherapy Incidence Medicine Medicine & Public Health Middle Aged Monoclonal antibodies Oncology Proportional Hazards Models Public Health Surveillance Risk Assessment Risk Factors Targeted cancer therapy Trastuzumab Trastuzumab - administration & dosage |
| title | Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database |
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