Table 5.
Prediction of Cardiovascular Death or Heart Failure Event- 2060 subjects (32 events).
| Univariable analysis | Multivariable analysis | ||||
|---|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | ||
| Age | 1.05 (1.02, 1.10) | 0.006 | |||
| Body mass index | 1.06 (1.01, 1.10) | 0.009 | |||
| Medical History | |||||
| Diabetes | 4.0 (1.8, 8.6) | <0.001 | |||
| Hypertension | 2.1 (1.0, 4.2) | 0.044 | |||
| Dyslipidemia | 2.9 (1.3, 6.2) | 0.007 | |||
| Coronary artery disease | 10.4 (3.7, 29.8) | <0.001 | |||
| Prior heart failure | 19.7 (6.9, 56.2) | <0.001 | 3.5 (1.1, 11.0) | 0.036 | |
| Chronic kidney disease | 3.1 (0.4, 23.0) | 0.261 | |||
| Chronic obstructive pulmonary disease | 3.1 (0.9, 10.2) | 0.061 | |||
| Smoking | 1.2 (0.8, 1.8) | 0.283 | |||
| Beta blocker | 5.2 (2.2, 12.0) | <0.001 | |||
| ACE-inhibitor | 2.6 (1.1, 5.9) | 0.027 | |||
| Angiotensin receptor blocker | 1.8 (0.7, 4.7) | 0.223 | |||
| Aldosterone antagonist | 0.0 (0.0, 0.0) | 1.000 | |||
| Statin | 2.6 (1.2, 5.8) | 0.018 | |||
| Breast Cancer Characteristics | |||||
| Cancer stage | 0 or 1 | Reference | |||
| 2 | 0.7 (0.2, 1.9) | 0.455 | |||
| 3 | 1.2 (0.4, 3.4) | 0.749 | |||
| Receptor status | Hormone positive, HER2 negative | Reference | |||
| HER2 positive | 0.8 (0.4, 1.8) | 0.61 | |||
| Triple negative | 1.3 (0.4, 3.8) | 0.635 | |||
| Cancer Therapy | |||||
| Use of anthracycline therapy | 0.97 (0.48, 1.94) | 0.931 | |||
| Anthracycline dose | 1.00 (1.00, 1.00) | 0.436 | |||
| Number of trastuzumab cycles | 0.97 (0.93, 1.02) | 0.26 | |||
| Left chest irradiation | 1.12 (0.48, 2.64) | 0.795 | |||
| Cardiac Imaging | |||||
| Baseline imaging (Echo vs. MUGA) | 1.0 (0.5, 2.1) | 0.92 | |||
| Baseline LVEF, per 1% increase | 1.1 (1.0, 1.1) | 0.025 | |||
| Occurrence of CTRCD | 3.4 (1.6, 7.2) | 0.001 | |||
| Follow-up cardiac imaging | All MUGA | Reference | |||
| All Echo | 10.5 (1.4, 79.5) | 0.023 | |||
| Mixed modality | 17.2 (2.3, 130.6) | 0.006 | |||
| None | 0.5 (0.0, 5.8) | 0.602 | |||
| HFA-ICOS risk | Low | Reference | |||
| Moderate | 2.4 (0.9, 6.2) | 0.069 | 2.4 (0.9, 6.2) | 0.069 | |
| High or Very high | 16.3 (6.6, 40.4) | <0.001 | 13.0 (4.9, 34.2) | <0.001 | |
All results are expressed as hazard ratio (95% confidence intervals) or frequency (percentage).
For this secondary outcome, parameters with univariable P<0.2 underwent stepwise forward selection. The final model includes prior heart failure 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.