Sutton Arnethea L, Zhao Jinlei, He Jian, Tossas Katherine Y, Bottinor Wendy, Sheppard Vanessa B
Department of Kinesiology and Health Sciences, Virginia Commonwealth University, P.O. Box 843021, Richmond, VA, 23220, USA.
VCU Massey Comprehensive Cancer Center, Richmond, VA, USA.
Breast Cancer Res Treat. 2025 Jun;211(2):537-544. doi: 10.1007/s10549-025-07671-0. Epub 2025 Mar 27.
Racial disparities exist regarding cardiovascular (CV) toxicities following breast cancer treatment; however, studies on racial differences in cardiac arrhythmias are lacking. This study examined associations between demographic and clinical factors and arrhythmia diagnosis in Black and White breast cancer survivors.
This study included a retrospective cohort of Black and White women who were diagnosed with breast cancer and who received potentially cardiotoxic treatment. Cardiac arrhythmia data were captured via International Classification of Diseases, Tenth and Ninth Versions (ICD-10 and ICD-9). Experiences with cardiac arrhythmias were compared across racial groups. The associations of demographic and clinical factors with cardiac arrhythmias were evaluated using logistic regression for all women and in race-stratified models.
Thirty-three percent of the total 860 women in our study sample (mean (standard deviation) age 50.3 (10.7) years) old) experienced cardiac arrhythmias. In bivariate analyses, we observed a statistically discernible association between race and arrhythmia status following a breast cancer diagnosis (p = 0.004); however, this association was no longer significant in the multivariable model. In race-stratified multivariable analysis, the odds of experiencing arrhythmias in Black women over 50 years old are 51% lower than in Black women aged 50 years old or younger (adjusted odds ratio (OR): 0.49; 95% confidence interval (CI): 0.28, 0.86). All else being equal, Black women with hypertension had 2.68 times (95% CI: 1.51, 4.81) higher odds of experiencing arrhythmias than those without hypertension. White women with obesity had higher odds of experiencing arrhythmias than those with normal weight or underweight status. (adjusted OR 1.93: [1.17, 3.20]).
Survivors with chronic conditions like hypertension and obesity may require enhanced cardiac surveillance. Further investigation into hypertension management in Black survivors may shed light on its impact on CV toxicities in this group.
乳腺癌治疗后的心血管毒性存在种族差异；然而，关于心律失常种族差异的研究尚缺。本研究调查了黑人和白人乳腺癌幸存者的人口统计学和临床因素与心律失常诊断之间的关联。
本研究纳入了一个回顾性队列，其中包括被诊断为乳腺癌且接受了可能具有心脏毒性治疗的黑人和白人女性。心律失常数据通过国际疾病分类第十版和第九版（ICD - 10和ICD - 9）获取。比较了不同种族群体中心律失常的发生情况。使用逻辑回归对所有女性以及按种族分层的模型评估人口统计学和临床因素与心律失常的关联。
我们研究样本中的860名女性（平均（标准差）年龄50.3（10.7）岁）中有33%经历过心律失常。在双变量分析中，我们观察到乳腺癌诊断后种族与心律失常状态之间存在统计学上可辨别的关联（p = 0.004）；然而，在多变量模型中这种关联不再显著。在按种族分层的多变量分析中，50岁以上黑人女性发生心律失常的几率比50岁及以下黑人女性低51%（调整后的优势比（OR）：0.49；95%置信区间（CI）：0.28，0.86）。在其他条件相同的情况下，患有高血压的黑人女性发生心律失常的几率是未患高血压黑人女性的2.68倍（95% CI：1.51，4.81）。肥胖的白人女性发生心律失常的几率高于体重正常或体重过轻的女性。（调整后的OR 1.93：[1.17，3.20]）。
患有高血压和肥胖等慢性病的幸存者可能需要加强心脏监测。对黑人幸存者高血压管理的进一步研究可能会揭示其对该群体心血管毒性的影响。
