SPC365

Cancer therapy–related cardiac dysfunction: incidence, risk factors and outcomes in a real-world cardio-oncology cohort

Session: Sessão de Posters 03 - Cardio-oncologia e doença sistémica: onde o cancro encontra o coração
Speaker: Isabel Maria Martins Moreira

Congress: CPC 2026
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.6 Cardio-Oncology
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Isabel Martins Moreira; Isabel Nóbrega Fernandes; Luís Sousa Azevedo; Matilde Pipa; Alzira Nunes; Inês Silveira; Ilídio Moreira

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Introduction:</span></strong><span style="font-family:&quot;Calibri&quot;,sans-serif"> Cancer therapy&ndash;related cardiac dysfunction (CTRCD) is a growing clinical challenge with prognostic implications. Despite increasing attention to risk stratification and cardioprotective drugs (CPD), optimal prevention and management strategies remain unclear.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Purpose:</span></strong><span style="font-family:&quot;Calibri&quot;,sans-serif"> To characterize the incidence, risk factors and outcomes associated with CTRCD.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods:</span></strong><span style="font-family:&quot;Calibri&quot;,sans-serif"> A retrospective study was conducted on patients referred to cardio-oncology outpatient clinic at our centre between May 2021 and July 2024. CTRCD were defined according to 2022 ESC Cardio-oncology guidelines. Demographic, clinical, echocardiographic, and laboratory data were analysed. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Results: A total of 135 patients (mean age of 67.8&plusmn;11.7 years, 62.2% male) were included. The most common malignancies were breast cancer (23.7%), gastrointestinal (22.2%), and hematological malignancies (17.8%); 42.9% had metastatic disease. Cardiovascular risk factors were prevalent: arterial hypertension (68.1%), dyslipidemia (65.9%), diabetes mellitus (37.0%), and smoking history (35.6%). At baseline, <span style="color:black">60.7% of the patients were on angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), or angiotensin receptor-neprilysin inhibitors (ARNi); 51.1% on betablockers (BB), 54.8% on statins, and 21.0% on SGLT2 inhibitors, primarily for comorbidities. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">CTRCD was observed in 25 patients (18.5%): 24% mild, 40% moderate and 36% severe, mostly asymptomatic (68%). The most frequent agents associated with CTRCD were trastuzumab (64%), anthracyclines (12%), BCR-ABL tyrosine-kinase inhibitors (8%), and</span> <span style="font-family:&quot;Calibri&quot;,sans-serif">epidermal growth factor receptor inhibitors (8%). CPD initiation or titration occurred in a significant proportion of patients (72% BB, 48% ACEi/ARBs/ ARNis, 72% SGLT2i and 16% statins) and 28% needed to suspend cancer treatment, with a complete recovery rate of 44% during a median follow-up of 20 [10, 32] months. There were no significant differences in cardiovascular mortality (4% vs 1.8%, p=0.504) and cardiovascular hospitalizations (12.0% vs 20.0%, p=0.353) between patients with and without CRTCD. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Patients receiving BB, statins or SGLT2i at baseline showed a significantly lower incidence of CTRCD compared with untreated patients (11.6% vs 25.8%, p=0.034; 12.2% vs 26.2%, p=0.036; and 3.4% vs 22.9%, p=0.018, respectively). Baseline ACEi/ARBs/ARNis use was not associated with a reduced risk of CTRCD (19.5% vs 17%, p=0.712).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusion:</span></strong> <span style="font-family:&quot;Calibri&quot;,sans-serif">In this study, CTRCD occurred in 18.5% of patients and was mostly asymptomatic. Pretreatment with BB, SGLT2i and statins was associated with a lower incidence of CTRCD. These findings highlight the importance of cardiovascular risk stratification and primary prevention in oncology patients, emphasizing the role of systematic cardiac surveillance and tailored therapeutic approaches to mitigate the risk of CRTCD in this vulnerable population.</span></span></span></p>