Exploring the Heart-Cancer Connection: CRIBbing Away Cardiovascular Risks in Breast Cancer

Macy Baugh - Department of Cardiology

Link:

https://www.sciencedirect.com/science/article/abs/pii/S1443950623042233?via%3Dihub

In the U.S., heart disease and cancer are the top two causes of mortality. While public health campaigns have made significant strides in raising awareness and preventing these diseases individually, their coexistence is often underemphasized. In particular, cardiovascular disease (CVD) and breast cancer share numerous risk factors, which impact disease management and outcomes in several ways. For instance, preexisting CVD can influence the selection and tolerance of cancer treatment. Furthermore, cancer therapies can lead to cardiotoxicity that can impact ongoing treatment. Additionally, latent cardiotoxicity can adversely impact cancer patient survivorship. With advances in breast cancer therapy leading to higher survival rates, CVD has emerged as a leading cause of death among these survivors. Prioritizing CVD risk reduction is imperative in the long-term care of oncology patients.

Currently, there is no widely accepted tool to predict cardiovascular outcomes in breast cancer patients. This study investigated the long-term cardiovascular prospects of early-stage breast cancer patients by introducing the Cardiovascular Risk Index in Breast Cancer (CRIB). This index aims to estimate the risk of major adverse cardiovascular events (MACEs) in women undergoing breast cancer treatment, accounting for factors like renal impairment, age over 65, body mass index (BMI) exceeding 27, diabetes, hypertension, and smoking history. A CRIB score exceeding 3 correlated with an elevated MACE risk. Among the 1,173 women studied, 6.8% encountered a MACE. These individuals tended to be older, had high CVD risk factors, and had a history of established coronary artery disease. 11.8% of women in the study died, and mortality rates were increased among those who experienced a MACE. Employing the novel CRIB method for cardiovascular risk assessment at the time of breast cancer diagnosis could be instrumental in guiding surveillance, the use of cardioprotective interventions, and identifying patients in need of long-term cardiac monitoring.

References:

1. Murphy, A. C., Koshy, A. N., Farouque, O., Yeo, B., Roccisano, L., Octavia, Y., & Yudi, M. B. (2023). Cardiovascular Disease in Patients With Breast Cancer Treated in the Modern Era. Heart, Lung and Circulation. https://doi.org/10.1016/j.hlc.2023.05.021