Background: Risk of heart failure (HF) is known to be higher among childhood cancer survivors as well as older adult cancer survivors who may already have cardiovascular disease risk factors. However, the risk of HF among young adult cancer survivors is not known. Aim: To examine incident HF in adult cancer survivors between 18-39 years of age. Methods: We identified patients who were aged 18-39 years when diagnosed with cancer based on the International Classification of Diseases (ICD) 9 and 10 at an integrated multisite single health system (Northwestern Medicine) between January 2000 and January 2019. We stratified by cancer types predominantly linked with anthracycline exposure (leukemia, lymphoma, sarcoma, breast, kidney, and bone cancers) compared with those less likely to have anthracycline exposure. We estimated the cumulative incidence of HF using the Kaplan-Meier method then calculated unadjusted and adjusted hazard ratios (HRs) for incident HF using Cox proportional hazard models. HRs were adjusted for demographic factors and cardiovascular risk factors. Results: Of 12,879 eligible patients, 35% were men and 68% White. The mean age was 31.5±5.7 years. Cardiovascular comorbidities were present in <5% of cancer survivors. During a median follow-up period of 3.4 (IQR, 1.3-7.1) years, 180 incident HF events were observed. Five-year cumulative incidence of HF was significantly higher in those cancer types more likely to have anthracycline exposure compared without (2.5% vs 0.6%, Log-rank p-value <0.01) with an adjusted HR for incident HF of 3.31 (95% confidence of interval 2.36-4.64, p<0.01). Conclusion: While cardiovascular comorbidities and HF are rare in the young adult population, undergoing cancer treatment with anthracycline exposure is associated with significantly higher risk for HF in young adult cancer survivors.
Citation Format: Yoshihiro Tanaka, Phlip Greenland, Sadiya Khan, Elizabeth A. Hibler. Incident heart failure among young adult cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB093.