Heart failure & cardiomyopathiesCohort study
Prognosis After Withdrawal of Cardioprotective Therapy in Patients With Improved Cancer Therapeutics–Related Cardiac Dysfunction
- Retrospective analysis of a prospective cohort study
- single-centre
Median follow-up after cancer therapeutics-related cardiac dysfunction (CTRCD) diagnosis 368.3 days (Q1-Q3: 160-536 days)
Authors' conclusion
Patients who withdrew CPT after demonstrating improvement in CTRCD experienced worse clinical outcomes. Notably, a significant decrease in LVEF was observed after CPT withdrawal in patients with a baseline LVEF <45%.
Study context
- Population
- Patients with improved cancer therapeutics-related cardiac dysfunction (left ventricular ejection fraction (LVEF) increase ≥10 percentage points from CTRCD diagnosis)
- Participants
- 134 patients
- Exposure
- Cardioprotective therapy (CPT) withdrawal vs CPT continuation after CTRCD improvement
- CGn = 90reference
- WGn = 44
- Outcome
- Composite of:
- HF hospitalization
- LVEF decrease ≥10 percentage points
- Follow-up
- Within 2 years after CTRCD improvement
Main finding
Composite major clinical events
Hazard ratio
3.06
95% CI 1.51–7.73
P = 0.002
WG vs CG
HR 3.06 (95% CI 1.51–7.73); P = 0.002
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mean
| Outcome | CG | WG | P value |
|---|---|---|---|
| Final LVEF, baseline LVEF 45%–55% (subgroup) | 64.9% (SD 4.4%) | 62.9% (SD 4.2%) | P = 0.059 |
| Final LVEF, baseline LVEF <45% (subgroup) | 53.3% (SD 6.4%) | 48.2% (SD 6.9%) | P < 0.001 |
Original publication
Prognosis After Withdrawal of Cardioprotective Therapy in Patients With Improved Cancer Therapeutics–Related Cardiac Dysfunction. JACC CardioOncol. Published 17 September 2024. doi:10.1016/j.jaccao.2024.07.018
Summarised from the published abstract; every number is checked against it