Breast cancer patients nonadherent to cardiac meds may face increased risk for cardiac events

  • Hershman DL & al.
  • Cancer
  • 8 Jan 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Patients with breast cancer who are nonadherent to cardiovascular disease risk factor (CVD-RF) medications may have a 15% increased risk for a cardiac event.

Why this matters

  • CVD is the foremost cause of death among patients with early breast cancer (eBCa).

Study design

  • Retrospective cohort (n=15,576) of the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database of patients with prescription drug coverage and who were taking at least 1 CVD-RF medication before their BCa diagnosis (2008-2013).
  • Medication adherence was defined as a medication possession ratio of ≥80%.
  • Funding: American Society of Clinical Oncology; others.

Key results

  • 30.8% of patients were nonadherent to ≥1 CVD-RF drug category after being treated for BCa.
  • Nonadherence was associated with:
    • black race (OR, 1.15; P=.03);
    • greater comorbidity burden (OR, 1.85; P<.0001>
    • more advanced cancer stage (OR, 1.15; P=.0002);
    • having received chemotherapy (OR, 1.14; P=.005); and
    • hormone receptor-negative disease (OR, 1.13; P=.02).
  • Nonadherence to ≥1 medication in the posttreatment period was associated with a borderline 15% increased risk for a cardiac event (HR, 1.15; P=.06).
  • The overall risk increased with nonadherence to a greater number of CVD-RF medications (P<.01>
  • The type of medication and affected risk:
    • nonadherence to hypertension medication (HR, 1.33; P<.0001>
    • nonadherence to hyperlipidemia medication (HR, 1.21; P=.009); and
    • nonadherence to diabetes medication (HR, 1.31; P=.003).

Limitations

  • Retrospective observational design.