Evidence map›Paper›PMID 39967196›Full record

ArticleJACC. CardioOncology2025

Impact of Pre-Existing Frailty on Cardiotoxicity Among Breast Cancer Patients Receiving Adjuvant Therapy.

Shuang Yang, Xiwei Lou, Mustafa M Ahmed, Stephen E Kimmel, Karen C Daily, Thomas J George, Carl J Pepine, Jiang Bian, Dejana Braithwaite, Dongyu Zhang and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shuang YangDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.
Xiwei LouDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.
Mustafa M AhmedDivision of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
Stephen E KimmelDepartment of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Karen C DailyDivision of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
Thomas J GeorgeDivision of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
Carl J PepineDivision of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
Jiang BianDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA; Cancer Informatics Shared Resource, University of Florida Health Cancer Center, Gainesville, Florida, USA.
Dejana BraithwaiteDepartment of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA; Department of Surgery, University of Florida, Gainesville, Florida, USA.
Dongyu ZhangJanssen Research and Development, LLC, Raritan, New Jersey, USA. Electronic address: dzhan107@its.jnj.com.
Yi GuoDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA; Cancer Informatics Shared Resource, University of Florida Health Cancer Center, Gainesville, Florida, USA. Electronic address: yiguo@ufl.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrior research suggests that breast cancer patients with a high burden of frailty may face an increased risk of cardiotoxicity.

objectivesThis study sought to examine the association between frailty and cardiotoxicity rates in female breast cancer patients receiving adjuvant therapy after surgery.

methodsWe analyzed data from the OneFlorida+ clinical research network, focusing on breast cancer patients treated with adjuvant chemotherapy and targeted therapy from 2012 to 2022. Cardiovascular rates during adjuvant treatments were calculated based on pre-existing frailty, measured using the cumulative deficit frailty index (electronic health record frailty index). We employed multivariable Gray's method to examine the association between frailty with cardiotoxicity.

resultsThe final cohort included 2,050 patients (mean age 50.6 years), with 415 (20.2%) experiencing nonfatal adverse cardiovascular events after adjuvant therapy. The incidence of adverse cardiovascular events was 17.8% in robust, 23.2% in prefrail, and 29.4% in frail patients. In multivariable analysis, prefrail (adjusted subdistribution HR [sHR]: 1.35; 95% CI: 1.06-1.71; P = 0.015) and frail (adjusted sHR: 1.70; 95% CI: 1.11-2.61; P = 0.015) patients had a higher likelihood of experiencing adverse cardiovascular events compared with robust patients. Among non-Hispanic White and Black patients, prefrail (adjusted sHR: 1.48; 95% CI: 1.04-2.11; P = 0.031; and adjusted sHR: 1.59; 95% CI: 1.06-2.37; P = 0.024, respectively) and frail (adjusted sHR: 1.96; 95% CI: 1.10-3.50; P = 0.022; and adjusted sHR: 2.13; 95% CI: 1.11-4.10; P = 0.023, respectively) patients were more likely to experience adverse cardiovascular events compared with robust patients. No significant differences were observed in other racial/ethnic groups.

conclusionsThese findings highlight the need for close monitoring of cardiotoxicity in frail breast cancer patients undergoing adjuvant treatments to improve cardiovascular risk management.

Indexed as

adjuvant treatmentbreast cancercardiotoxicityelectronic health recordsfrailtygeriatric oncologyoutcomesreal-world datarisk factortreatmentwomen's oncology

Identifiers

PMID39967196
PMCPMC11866446

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.