Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Exercise-Based Rehabilitation for Heart Failure: Cochrane Systematic Review, Meta-Analysis, and Trial Sequential Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Burden and Causes of Hospital Admissions in Heart Failure During the Last Year of Life

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Reply: Physical Activity and Fitness in Heart Failure With Preserved Ejection Fraction: Ready for Prime Time?

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Central and Peripheral Determinants of Exercise Capacity in Heart Failure Patients With Preserved Ejection Fraction

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Income Inequality and Outcomes in Heart Failure: A Global Between-Country Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Objectives: This study sought to evaluate the long-term risk of developing heart failure (HF) in patients receiving trastuzumab therapy. Background: Trastuzumab has improved the prognosis in patients with HER2-positive breast cancer, but it can induce left ventricular dysfunction with reduced ejection fraction or HF during treatment. The long-term risk of HF is less well described. Methods: In a nationwide Danish retrospective cohort study, 9,901 patients scheduled for adjuvant treatment for early-stage breast cancer were identified in the Danish Breast Cancer Cooperative Group database. Of these, 8,812 patients (25% HER2-positive; 51.7 ± 8.5 years of age) received chemotherapy including anthracycline; and if they were HER2 positive, trastuzumab was added. The primary endpoint was a diagnosis of HF assessed before and after 18 months in a landmark analysis to distinguish short- and long-term risks. Results: Median follow-up was 5.4 years (interquartile range [IQR]: 4.1 to 6.8 years). In the trastuzumab group, 60 patients had HF by 9 years versus 51 in the group who were treated with chemotherapy alone, corresponding to incidence rates per 1,000 patient years of 5.3 (95% confidence interval [CI]: 4.1 to 6.8) versus 1.4 (95% CI: 1.1 to 1.8), respectively. The cumulative incidence of HF was higher in the trastuzumab group at both the short- and long-term (p < 0.01), yielding adjusted hazard ratios of 8.7 (95% CI: 4.6 to 16.5; p < 0.01) for early HF and 1.9 (95% CI: 1.2 to 3.3; p = 0.01) for late HF associated with trastuzumab treatment. Conclusions: Trastuzumab treatment is associated with a 2-fold increased risk of late HF compared with chemotherapy treatment alone.

Original languageEnglish
JournalJACC. Heart failure
Volume7
Issue number3
Pages (from-to)217-224
Number of pages8
ISSN2213-1779
DOIs
Publication statusPublished - 1 Mar 2019

    Research areas

  • breast cancer, cardiotoxicity, epidemiology, heart failure, trastuzumab

ID: 56977757