Clinical predictors of cardiotoxicity in a large cardio-oncology cohort: a caribbean registry analysis

Background: Advances in cancer therapy have significantly improved survival, leading to a growing population of patients at risk for treatment-related cardiovascular complications. Cardiotoxicity, which includes ventricular dysfunction, arrhythmias, and structural heart disease, has emerged as a major determinant of morbidity and mortality in oncology patients. While several risk factors have been identified, including age, comorbidities, and type of cancer therapy, most evidence derives from North American and European populations. Data from Latin America and the Caribbean remain limited, despite differences in healthcare access, cardiovascular risk profiles, and cancer epidemiology. Understanding region-specific predictors of cardiotoxicity is essential to optimize surveillance strategies and guide personalized cardio-oncology care. Purpose: To identify clinical and oncologic predictors of cardiotoxicity in a contemporary cardio-oncology cohort. Methods: We conducted a cross-sectional study of 3,211 oncology patients evaluated in a dedicated cardio-oncology clinic in the Caribbean between October 2023 and September 2025. Demographic, cardiovascular, and oncologic variables, including cancer type, were analyzed. Cardiotoxicity was defined as ventricular dysfunction, arrhythmia, or structural abnormalities attributable to cancer therapy. Results: Among 3,211 patients (mean age 58.1 ± 14.9 years; 65.7% female), breast cancer was the most common malignancy (43%), followed by colorectal (10%) and lung cancer. Cardiotoxicity was observed in 15.8% of patients. A higher prevalence was noted in men compared with women (22.4% vs 12.1%; p