Abstract
Title Incidence of cancer therapy related cardiac dysfunction (CTRCD) in Māori vs non-Māori
Aim: Survival disparities continue to exist between Māori and non-Māori across most cancers. In this study we investigated whether there were higher rates of CTRCD detected by echocardiography in Māori, which could contribute to poorer outcomes.
Method: We conducted a retrospective audit of patients dispensed with Trastuzumab, Pertuzumab and/or Doxorubicin chemotherapy agents, and with serial echocardiography performed, at Lakes and Bay of Plenty District Health Boards between January 2018 - January 2021. Baseline demographic, cancer and cardiovascular disease (CVD) risk information were compared. CTRCD was classified using current guidelines. Chi-squared and binary regression tests were used to compare incidence rates and outcomes.
Results: Māori patients were more likely to smoke (p = 0.0002), had previously smoked (p = 0.04) and were less likely to be over 65 years old (p = 0.003) than non-Māori patients. CTRCD was observed in 25 of 107 patients (23%). In Māori patients 17 of 58 (29%) developed CTRCD compared to 8 of 49 (16%) in non-Māori, although this difference was not statistically significant (p = 0.11). Smoking was associated with CTRCD (p = 0.003). CTRCD was associated with mortality in univariate analysis (p = 0.02), but not in multivariate analysis (0.06).
Conclusion: There was a non-significant trend towards more Māori developing CTRCD, with larger studies needed to investigate this association. Assessing for association of CTRCD to CVD risk factors was limited by a lack of confirmed absence of risk factors. CTRCD was associated with mortality in univariate analysis, further prospective research is suggested.