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. 2023 Aug 17;11(8):2286. doi: 10.3390/biomedicines11082286

Table 1.

Examples of racial disparities in anthracycline-induced cardiotoxicity.

Study Design Population Treatment Dose Cardiotoxicity Outcomes Conclusion
Toure et al., 2022 [57] Retrospective observational study 8604 (274 African American and 8330 White participants) Doxorubicin (dose ranged from 400 mg/m2 to 700 mg/m2) Congestive heart failure (CHF) was detected in 27.8% of White participants and 32.5% of African Americans. Significant differences
between African Americans and White patients in hazard of incident CHF and cumulative incidence of incident CHF.
Collin et al., 2020 [58] Prospective observational study 8503 (3580 African American and 4923 non-Hispanic White (NHW) participants) Not specified Anthracyclines were associated with a greater hazard ratio in African Americans (HR, 1.45) than in White breast cancer survivors (HR, 0.86); data were not statistically significant. Disparity in chemotherapy-induced cardiotoxicity
between African American and White breast cancer survivors contributed to the racial disparity in overall survival between these groups.
Troeschel et al., 2019 [28] Retrospective observational study 407,587 (36,458 NHW) and 43,562 African American) Not specified The 20-year cumulative incidence of CVD-related mortality was 13.3% in African American women and 8.9% in NHW.
Higher hazard ratio of cardiovascular mortality in African American breast cancer survivors compared with White breast cancer survivors (HR = 2.73 for those less than 50 and 1.72 for those aged 55 to 68 years).
CVD-related mortality was significantly higher among African American than NHW breast cancer survivors, especially the young.
Berkman et al., 2014 [59] Retrospective observational study 67,514 (54,518 White and 6113 African American participants) Not specified Higher hazard ratio of cardiovascular mortality in African American t cancer survivors compared with White breast cancer survivors (HR = 14.99 for the age group 40–49, HR = 6.43 for the age group 50–59, and HR = 2.26 for the age group 60–69). Cardiovascular mortality was significantly higher in African American breast cancer survivors, especially among the young.
Braithwaite et al., 2009 [27] Retrospective observational study 1254 (416 African American and 838 White participants) Not specified All-cause mortality was 39.7% in African Americans vs. 33.3% in White patients. The association between hypertension and all-cause survival accounted for 30% of the racial disparity in this outcome. Hypertension is an independent predictor of the disparity between African American and White breast cancer survivors in cardiovascular outcomes and survival.
Hasan et al., 2004 [26] Retrospective observational study 499 (100 African Americans and 399 White patients) The median of cumulative doxorubicin dose infused over 48 h is 374 mg/m2; the range is between 264 and 580 mg/m2 Higher incidence of doxorubicin-induced cardiotoxicity (LVEF less than 45%) among African American patients (7%) compared to White patients (2.5%). Doxorubicin-induced cardiotoxicity is more in African American than in White patients.