CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer
Abstract Background Cardiovascular (CV) comorbidities and concurrent medications with risk of heart rate-corrected QT interval (QTc) prolongation can impact treatment decisions and safety discussions for patients with breast cancer. However, limited data are available regarding their prevalence in p...
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BMC
2025-01-01
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| Series: | Cardio-Oncology |
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| Online Access: | https://doi.org/10.1186/s40959-025-00305-w |
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| author | Susan Dent Avirup Guha Heather Moore Doris Makari Rachael McCaleb Irene Arias Stella Stergiopoulos Benjamin Li Michael Fradley |
| author_facet | Susan Dent Avirup Guha Heather Moore Doris Makari Rachael McCaleb Irene Arias Stella Stergiopoulos Benjamin Li Michael Fradley |
| author_sort | Susan Dent |
| collection | DOAJ |
| description | Abstract Background Cardiovascular (CV) comorbidities and concurrent medications with risk of heart rate-corrected QT interval (QTc) prolongation can impact treatment decisions and safety discussions for patients with breast cancer. However, limited data are available regarding their prevalence in patients with HR + /HER2– metastatic breast cancer (mBC). We evaluated the prevalence of CV comorbidities, the use of concurrent medications with risk of QTc prolongation, and treatment patterns in patients with newly diagnosed HR + /HER2 − mBC. Methods This retrospective analysis utilized claims data from Merative™ Marketscan® Commercial and Medicare databases. Claims-based algorithms identified patients with newly diagnosed HR + /HER2– mBC between January 2016 and December 2022. The index date was defined as the first date of an mBC claim during this period. For each patient, data on pre-existing CV comorbidities and first-line treatments were captured for 12 months before and 6 months after the index date, respectively. Results A total of 6525 patients with newly diagnosed HR + /HER2 − mBC were identified. At mBC diagnosis, 61.7% of patients had ≥ 1 CV comorbidity. Of patients with CV comorbidities, 22.5% and 30.6% took 1 or ≥ 2 medications, respectively, with risk of QTc prolongation. First-line use of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors increased from 22.1% of patients with CV comorbidities diagnosed in 2016–2017 to 31.5% of those diagnosed in 2018–2022. Conclusions We found that CV comorbidities and use of medications with risk of QTc prolongation were common in patients with newly diagnosed HR + /HER2 − mBC. These factors should inform treatment decision-making (including CDK4/6 inhibitor selection), safety discussions with patients, and CV monitoring. Graphical Abstract |
| format | Article |
| id | doaj-art-7e98186149a6430e9eaf75376f014576 |
| institution | Kabale University |
| issn | 2057-3804 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardio-Oncology |
| spelling | doaj-art-7e98186149a6430e9eaf75376f0145762025-02-02T12:44:37ZengBMCCardio-Oncology2057-38042025-01-0111111310.1186/s40959-025-00305-wCARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancerSusan Dent0Avirup Guha1Heather Moore2Doris Makari3Rachael McCaleb4Irene Arias5Stella Stergiopoulos6Benjamin Li7Michael Fradley8Wilmot Cancer Institute, Department of Medicine, University of RochesterDepartment of Medicine, Medical College of Georgia, Augusta UniversityDuke Cancer Institute, Department of Medicine, Duke UniversityPfizer IncPfizer IncPfizer IncPfizer IncPfizer IncThalheimer Center for Cardio-Oncology, Division of Cardiology, Hospital of the University of PennsylvaniaAbstract Background Cardiovascular (CV) comorbidities and concurrent medications with risk of heart rate-corrected QT interval (QTc) prolongation can impact treatment decisions and safety discussions for patients with breast cancer. However, limited data are available regarding their prevalence in patients with HR + /HER2– metastatic breast cancer (mBC). We evaluated the prevalence of CV comorbidities, the use of concurrent medications with risk of QTc prolongation, and treatment patterns in patients with newly diagnosed HR + /HER2 − mBC. Methods This retrospective analysis utilized claims data from Merative™ Marketscan® Commercial and Medicare databases. Claims-based algorithms identified patients with newly diagnosed HR + /HER2– mBC between January 2016 and December 2022. The index date was defined as the first date of an mBC claim during this period. For each patient, data on pre-existing CV comorbidities and first-line treatments were captured for 12 months before and 6 months after the index date, respectively. Results A total of 6525 patients with newly diagnosed HR + /HER2 − mBC were identified. At mBC diagnosis, 61.7% of patients had ≥ 1 CV comorbidity. Of patients with CV comorbidities, 22.5% and 30.6% took 1 or ≥ 2 medications, respectively, with risk of QTc prolongation. First-line use of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors increased from 22.1% of patients with CV comorbidities diagnosed in 2016–2017 to 31.5% of those diagnosed in 2018–2022. Conclusions We found that CV comorbidities and use of medications with risk of QTc prolongation were common in patients with newly diagnosed HR + /HER2 − mBC. These factors should inform treatment decision-making (including CDK4/6 inhibitor selection), safety discussions with patients, and CV monitoring. Graphical Abstracthttps://doi.org/10.1186/s40959-025-00305-wCardiovascular comorbiditiesCyclin-dependent kinase 4/6 inhibitorHR + /HER2–Medical claimsMetastatic breast cancerQTc prolongation |
| spellingShingle | Susan Dent Avirup Guha Heather Moore Doris Makari Rachael McCaleb Irene Arias Stella Stergiopoulos Benjamin Li Michael Fradley CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer Cardio-Oncology Cardiovascular comorbidities Cyclin-dependent kinase 4/6 inhibitor HR + /HER2– Medical claims Metastatic breast cancer QTc prolongation |
| title | CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer |
| title_full | CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer |
| title_fullStr | CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer |
| title_full_unstemmed | CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer |
| title_short | CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer |
| title_sort | cardiac star prevalence of cardiovascular comorbidities in patients with hr her2 metastatic breast cancer |
| topic | Cardiovascular comorbidities Cyclin-dependent kinase 4/6 inhibitor HR + /HER2– Medical claims Metastatic breast cancer QTc prolongation |
| url | https://doi.org/10.1186/s40959-025-00305-w |
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