Table 4.
Prediction of All-Cause Death or Heart Failure Event- 2060 subjects (212 events).
| Univariable analysis | Multivariable analysis | ||||
|---|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | ||
| Age | 1.01 (1.00, 1.02) | 0.131 | |||
| Body mass index | 1.00 (0.98, 1.02) | 0.748 | |||
| Medical History | |||||
| Diabetes | 1.4 (0.9, 2.1) | 0.143 | |||
| Hypertension | 1.3 (0.9, 1.7) | 0.136 | |||
| Dyslipidemia | 1.1 (0.7, 1.6) | 0.731 | |||
| Coronary artery disease | 2.1 (0.9, 4.8) | 0.071 | |||
| Prior heart failure | 4.2 (1.9, 9.5) | 0.001 | |||
| Chronic kidney disease | 3.0 (1.3, 6.7) | 0.008 | 2.6 (1.1, 5.9) | 0.024 | |
| Chronic obstructive pulmonary disease | 2.1 (1.2, 3.7) | 0.006 | 1.9 (1.1, 3.3) | 0.019 | |
| Smoking | 1.0 (0.9, 1.2) | 0.958 | |||
| Beta blocker | 1.2 (0.7, 2.1) | 0.497 | |||
| ACE-inhibitor | 1.0 (0.6, 1.6) | 0.999 | |||
| Angiotensin receptor blocker | 1.4 (1.0, 2.2) | 0.078 | |||
| Aldosterone antagonist | 6.6 (2.1, 20.5) | 0.001 | 6.3 (1.9, 20.1) | 0.002 | |
| Statin | 1.0 (0.7, 1.6) | 0.853 | |||
| Breast Cancer Characteristics | |||||
| Cancer stage | 0 or 1 | Reference | |||
| 2 | 1.4 (0.8, 2.4) | 0.25 | 1.3 (0.7, 2.3) | 0.415 | |
| 3 | 3.9 (2.2, 6.8) | <0.001 | 3.7 (2.1, 6.6) | <0.001 | |
| Receptor status | Hormone positive, HER2 negative | Reference | |||
| HER2 positive | 0.8 (0.6, 1.2) | 0.294 | 1.6 (0.8, 3.1) | 0.154 | |
| Triple negative | 2.8 (2.0, 3.9) | <0.001 | 3.0 (2.1, 4.2) | <0.001 | |
| Cancer Therapy | |||||
| Use of anthracycline therapy | 1.17 (0.89, 1.54) | 0.251 | |||
| Anthracycline dose | 1.00 (1.00, 1.00) | 0.704 | |||
| Number of trastuzumab cycles | 0.97 (0.95, 0.99) | 0.003 | 1.0 (0.9, 1.0) | 0.064 | |
| Left chest irradiation | 0.96 (0.71, 1.31) | 0.799 | |||
| Cardiac Imaging | |||||
| Baseline imaging (Echo vs. MUGA) | 0.8 (0.6, 1.1) | 0.159 | |||
| Baseline LVEF, per 1% increase | 1.0 (1.0, 1.0) | 0.429 | |||
| Occurrence of CTRCD | 1.2 (0.8, 1.8) | 0.264 | |||
| Follow-up cardiac imaging | All MUGA | Reference | |||
| All Echo | 0.9 (0.5, 1.4) | 0.517 | |||
| Mixed modality | 1.4 (0.9, 2.3) | 0.136 | |||
| None | 0.9 (0.6, 1.3) | 0.532 | |||
| HFA-ICOS risk | Low | Reference | |||
| Moderate | 1.2 (0.9, 1.6) | 0.319 | 1.0 (0.8, 1.4) | 0.961 | |
| High or Very high | 2.1 (1.4, 3.3) | <0.001 | 2.2 (1.4, 3.4) | <0.001 | |
All results are expressed as hazard ratio (95% confidence intervals) or frequency (percentage).
For the composite outcome, the above parameters with univariable P<0.2 underwent stepwise forward selection. The final model includes chronic kidney disease, chronic obstructive pulmonary disease, aldosterone antagonist, cancer stage 3, triple negative receptor status and “high or very high” HFA-ICOS risk. Other parameters are no longer significant in the multivariable model.
HR, hazard ratio; CI, confidence intervals; MUGA, multi-gated acquisition; ACE, angiotensin converting enzyme; HER2, human epidermal growth factor receptor-2; CTRCD, cancer therapy related cardiac dysfunction; HFA-ICOS, European Society of Cardiology Heart Failure Association - International Cardio-Oncology Society.