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- Title
Outcomes of malignancy in adults with congenital heart disease: a single center experience.
- Authors
Venkatesh, Prashanth; Yan, Kimberly L.; Bravo-Jaimes, Katia; Yang, Eric H.; Lluri, Gentian
- Abstract
Background: Malignancy is known to be a major cause of death in adult congenital heart disease (ACHD). However, data regarding cardiovascular and cancer-related outcomes in ACHD are lacking. Methods: We conducted a retrospective single-center cohort study comprising patients with ACHD and malignancy. The primary outcome was all-cause mortality. Key secondary outcomes included major adverse cardiovascular and cerebrovascular events (MACCE), cardiotoxicity events and consequent cancer therapy modifications. Results: Sixty-eight patients with ACHD and a history of cancer were included in the study. 82% of patients had moderate or great ACHD anatomic complexity. Over a median follow-up of 5 years after cancer diagnosis, 16 (24%) patients died, with 69% of deaths being due to cancer. Univariate predictors of mortality were baseline arrhythmia (OR 3.82, 95% CI 1.15-12.67, p = 0.028), baseline diuretic therapy (OR 3.54, 95% CI 1.04-12.04, p = 0.044) and advanced cancer stage at diagnosis (OR 2.37, 95% CI 1.32-4.25, p = 0.004). MACCE occurred in 40 (59%) patients and was independently predicted by baseline diuretic requirement (OR 9.91, 95% CI 1.12-87.85, p = 0.039). A 14% incidence of cardiotoxicity was seen; 3 patients needed modification and 1 patient needed temporary interruption of cancer therapy for 2 weeks. Conclusions: Considerable mortality occurred in this cohort of patients with ACHD and cancer; most deaths were cancer-related. A high rate of MACCE was observed, yet rates of obligatory modification of cancer therapy due to cardiotoxicity were low.
- Subjects
CALIFORNIA; TUMOR risk factors; TUMOR treatment; CEREBROVASCULAR disease risk factors; CARDIOVASCULAR diseases risk factors; CAUSES of death; CARDIOTOXICITY; STATISTICS; DIURETICS; ECHOCARDIOGRAPHY; CONFIDENCE intervals; ACADEMIC medical centers; MULTIPLE regression analysis; MULTIVARIATE analysis; LOG-rank test; AGE distribution; CONGENITAL heart disease; RETROSPECTIVE studies; CARDIOVASCULAR diseases; DISEASE incidence; ACQUISITION of data; MAGNETIC resonance imaging; FISHER exact test; RISK assessment; CANCER patients; COMPARATIVE studies; PEARSON correlation (Statistics); TREATMENT effectiveness; DESCRIPTIVE statistics; MEDICAL records; CHI-squared test; KAPLAN-Meier estimator; AGE factors in disease; TUMORS; ARRHYTHMIA; ODDS ratio; PEPTIDE hormones; DATA analysis software; LONGITUDINAL method; DISEASE complications; ADULTS
- Publication
Cardio-Oncology, 2022, Vol 8, Issue 1, p1
- ISSN
2057-3804
- Publication type
Article
- DOI
10.1186/s40959-022-00144-z