Table 2
Baseline demographic and clinical characteristics of both cohorts.
| DR (n = 330) | US (n = 267) | TOTAL (n = 597) | p | |
|---|---|---|---|---|
| Mean age – (yrs.) | 55 ± 13 | 52 ± 13 | 54 ± 13 | |
| Female gender – n (%) | 254 (77) | 232 (87) | 486 (81) | p < 0.001 |
| Type of cancer – n (%) | ||||
| Breast cancer | 189 (57) | 195 (73) | 384 (64) | p < 0.001 |
| Colon cancer | 36 (11) | 0 | 36 (6) | p < 0.001 |
| Non-Hodgkin’s Lymphoma | 11 (3) | 22 (8) | 33 (6) | p < 0.005 |
| Lung cancer | 20 (6) | 3 (1) | 23 (4) | p < 0.005 |
| Hodgkin’s Lymphoma | 10 (3) | 11 (4) | 21 (4) | p = 0.072 |
| Cardiovascular risk factors – n (%) | ||||
| HTN | 166 (50) | 98 (37) | 264 (44) | p < 0.005 |
| DM | 44 (13) | 44 (16) | 88 (15) | p = 0.163 |
| Smoking | 53 (16) | 25 (9) | 78 (13) | p < 0.001 |
| BMI ≥ 30 | 108 (33) | 87 (33) | 195 (33) | p = 0.524 |
| DLP | 52 (16) | 80 (30) | 132 (22) | p < 0.005 |
| ≥ 2 risk factors | 131 (39 | 94 (35) | 225 (38) | p = 0.142 |
| Treatment – n (%) | ||||
| Cardioprotective drugs | 160 (48) | 114 (43) | 274 (92) | p = 0.095 |
| Radiotherapy | 145 (44) | 162 (61) | 283 (47%) | p = 0.001 |
| Treated with anthracyclines + taxanes | 151 (47) | 106 (40) | 257 (87) | p = 0.151 |
| Treated with monoclonal antibodies + taxanes or platins | 124 (37) | 122 (45) | 246 (83) | p < 0.001 |
| Developed cardiotoxicity – n (%) | 51 (15) | 20 (7) | 71 (24) | p < 0.001 |
[i] BMI: body mass index, DLP: dyslipidemia, DM: diabetes mellitus, DR: Dominican Republic, HTN: hypertension, US: United States.
Figure 1
Central Illustration. Cardiovascular risk factors and rate of cancer therapy-induced cardiotoxicity.
Legend: BMI: body mass index, DLP: dyslipidemia, DM: diabetes mellitus, DR: Dominican Republic, HTN: hypertension, US: United States. * p =< 0.001.
Table 2
Multivariate logistic regression analysis for cancer therapy-induced cardiotoxicity.
| ODDS RATIO | 95% | CI | p | |
|---|---|---|---|---|
| DR/US | 2.24 | 1.28 | 3.91 | <0.004 |
| Hypertension | 1.35 | 0.76 | 2.40 | 0.295 |
| Diabetes mellitus | 1.43 | 0.71 | 2.87 | 0.311 |
| BMI ≥ 30 | 1.16 | 0.68 | 1.96 | 0.579 |
| Tobacco use | 0.97 | 0.46 | 2.02 | 0.937 |
| Age ≥ 60 years | 0.65 | 0.36 | 1.17 | 0.157 |
| Chemo: Anthracyclines + Taxanes | 1.48 | 0.87 | 2.52 | 0.142 |
| Chemo: Trastuzumab + Taxanes or Platins | 1.05 | 0.61 | 1.82 | 0.837 |
[i] BMI: body mass index, CI: confidence interval, DR: Dominican Republic, US: United States.
Table 3
Adherence to American Society of Clinical Oncology Guidelines.
| RECOMMENDATIONS | DR | US | p |
|---|---|---|---|
| Pre-treatment preventive strategies to reduce risk | n = 330 (%) | n = 267 (%) | |
| Cardiovascular evaluation | 330 (100) | 267 (100) | p = 0.47 |
| Echocardiogram | 330 (100) | 267 (100) | p = 0.47 |
| Already on cardioprotective drugs | 160 (48) | 114 (43) | p = 0.095 |
| Management during cancer treatment | |||
| Follow-up echocardiogram | 180 (54) | 99 (37) | p =< 0.001 |
| >1 echo during treatment | 38 (12) | 50 (19) | p = 0.009 |
| Use of biomarkers | 152 (46) | 39 (18) | p =< 0.001 |
| Developed cardiotoxicity | 51 (15) | 20 (7) | p =< 0.001 |
| Cardio-oncology clinic follow up | 180 (54) | 99 (37) | p =< 0.001 |
| Monitoring after cancer treatment | |||
| Cardio-oncology clinic follow-up | 180 (54) | 99 (37) | p =< 0.001 |
| Surveillance echocardiogram | 180 (54) | 99 (37) | p =< 0.001 |
[i] DR: Dominican Republic, US: United States.