Factors Associated with Developing Cancer Therapy-Related Cardiac Dysfunction Differ by Cancer Diagnosis

Background: Cancer and cardiovascular disease are the two leading causes of death in Canada. Although treatments have improved tremendously across the years, interventions such as radiotherapy and chemotherapies are known to have negative impacts on cardiovascular health and can lead to death if not treated in time. Using a retrospective approach, we determined factors associated with cancer therapy-related cardiac dysfunction (CTRCD). Methods: Patients followed through a dedicated Cardio-Oncology clinic with comprehensive screening for CTRCD were identified. CTRCD was defined as a drop in left ventricular ejection fraction of at least 10% to a value lower than 53%. We performed multivariable logistic regression to determine factors associated with CTRCD. Results: In total, 2460 patients with cancer were identified from clinical records—919 had breast cancer, 758 had hematologic malignancies, and 783 had other cancer types. Patients with breast cancer and hematologic malignancies were more likely to experience CTRCD, with odds ratios (ORs) of 2.10 (p = 0.059) and 1.96 (p = 0.047), respectively. Anthracycline and trastuzumab use were independently associated with CTRCD, with ORs of 1.98 (p = 0.002) and 3.19 (p < 0.001), respectively. In hematologic malignancy patients, hypertension (OR = 2.18, p = 0.047) and diabetes (OR = 2.31, p = 0.036) were also significant predictors of CTRCD. Conclusions: We confirmed the importance of anthracycline, trastuzumab, and radiation in the development of CTRCD. However, among patients with hematologic malignancies, traditional cardiovascular risk factors are also associated with CTRCD. This information could help physicians personalize CTRCD surveillance strategies.