scholarly journals Heart failure and dementia: A comparative analysis with different types of cancer

2021 ◽  
Author(s):  
Christoph Roderburg ◽  
Sven H Loosen ◽  
Markus S Jördens ◽  
Marcel Konrad ◽  
Tom Luedde ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Heart Failure ◽  
Cognitive Decline ◽  
Cancer Patients ◽  
Cox Regression ◽  
Digestive Organ ◽  
Patients With Heart Failure ◽  
Icd 10 ◽  
Incidence Of Dementia

Abstract Objectives The prognosis and quality of life of heart failure (HF) patients is determined by comorbidities, with dementia/cognitive decline believed to have a significant impact in this regard. This study compares the incidence of dementia in heart failure patients with that in patients with common cancers in a large collective of outpatients. Methods and Results This retrospective cohort study assessed the incidence of dementia/cognitive decline (ICD-10: I50) in a cohort of patients ≥65 years diagnosed with HF (ICD-10: I50), breast cancer (ICD-10: C50), prostate cancer (ICD-10: C61), or digestive organ cancer (ICD-10: C15-C26) in 1,274 German general practices between January 2000 and December 2018. Multivariable Cox regression models were used to study the association between HF and dementia compared to each of three cancer cohorts. We included 72,259 patients with heart failure, 10,310 patients with breast cancer, 12,477 patients with prostate cancer and 12,136 patients with digestive organ cancer. 27.8% of HF patients were diagnosed with dementia during the 10-year observation period compared to 16.2% of breast cancer patients, 18.6% of patients with digestive organ cancer, and 16.1% of patients with prostate cancer. HF patients were significantly more likely to develop dementia within 10 years after diagnosis than patients with breast cancer (hazard ratio [HR]: 1.36 (95% confidence interval 1.28-1.45, P < 0.001), prostate cancer (HR 1.38 (1.130-1.47), P < 0.001), or gastrointestinal tumors (HR 1.31 (1.24-1.39), P < 0.001). Conclusions Our study demonstrates the significance of dementia in patients with heart failure, in whom the condition is much more prevalent than in cancer patients.

Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using electronic medical records.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6589-6589
Author(s):  
Aaron Galaznik ◽  
Emelly Rusli ◽  
Vicki Wing ◽  
Rahul Jain ◽  
Sheila Diamond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Cancer Patients ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Research Database ◽  
Breast Cancer Cohort ◽  
Icd 10

6589 Background: While patients with cancer are known to be at increased risk of infection in part due to the immunocompromising nature of cancer treatments, recent data indicate a particularly high risk for COVID-19 infection and poor outcomes (Wang et al., 2020). A recent study (Meltzer et al., 2020) demonstrated Vitamin D deficiency may increase risk of COVID-19 infection, and a small randomized controlled trial in Spain reported significant improvement in mortality among hospitalized patients treated with calcifediol. Vitamin D deficiency has been reported in two leading causes of cancer deaths: breast and prostate. In this study, we performed a retrospective cohort analysis on nationally representative electronic medical records (EMR) to assess whether Vitamin D deficiency affects risk of COVID-19 among these patients. Methods: Patients with breast (female) or prostate (male) cancer were identified between 3/1/2018 and 3/1/2020 from EMR data provided pro-bono by the COVID-19 Research Database ( covid19researchdatabase.org ). Patients with an ICD-10 code for Vitamin D deficiency or < 20ng/mL 20(OH)D laboratory result within 12 months prior to 3/1/2020 were classified as Vitamin D deficient. COVID-19 diagnosis was defined using ICD-10 codes and laboratory results for COVID-19 at any time after 3/1/2020. Logistic regressions, adjusting for baseline demographic and clinical characteristics, were conducted to estimate the effect of Vitamin D deficiency on COVID-19 incidence in each cancer cohort. Results: A total of 16,287 breast cancer and 14,919 prostate cancer patients were included in the study. The average age was 68.9 years in the breast cancer cohort and 73.6 years in the prostate cancer cohort. The breast cancer cohort consisted of 85% Whites, 13% Black or African Americans, and less than 5% of other races. A similar race distribution was observed in the prostate cancer cohort. Unadjusted analysis showed the risk of COVID-19 was higher among Vitamin D deficient patients compared to non-deficient patients in both cohorts (breast: OR = 1.60 [95% C.I.: 1.15, 2.20]; prostate: OR = 1.59 [95% C.I.: 1.08, 2.33]). Similar findings were observed when assessed in subgroups of patients with newly diagnosed cancer in the dataset, as well as after adjusting for baseline characteristics. Conclusions: Our study suggests breast and prostate cancer patients may have an elevated risk of COVID-19 infection if Vitamin D deficient. These results support findings by Meltzer et al., 2020 demonstrating a relationship between Vitamin D deficiency and COVID-19 infection. While a randomized clinical trial is warranted to confirm the role for Vitamin D supplementation in preventing COVID-19, our study underscores the importance of monitoring Vitamin D levels across and within cancer populations, particularly in the midst of the global COVID-19 pandemic.

scholarly journals EFFECTS OF TRASTUZUMAB ON MYOCARDIAL FUNCTION ON BREAST CANCER PATIENTS

2021 ◽  
Vol 62 (4) ◽  
Author(s):  
Bui Dang Minh Tri ◽  
Le Cong Duy Anh ◽  
Do Van Mai ◽  
Nguyen Huu Phuc ◽  
Nguyen Thi Thuy Linh
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Retrospective Study ◽  
Cancer Patients ◽  
Diagnostic Criteria ◽  
Myocardial Function ◽  
Breast Cancer Patients ◽  
Patients With Heart Failure ◽  
Discontinue Therapy

Objective: To investigate the effect of Trastuzumab on myocardial function on breast cancer patients at Thong Nhat hospital. Subjects and methods: a retrospective study on 48 patients with breast cancer treated with Trastuzumab at Thong Nhat hospital. Results: Percentage of patients with heart failure according to the Frammingham diagnostic criteria was 4.17%. The proportion of patients with no symptoms of heart failure according to Frammingham diagnostic criteria was 95.83%. According to the degree of EF change, the proportion of patients with decreased EF > 10% after treatment was 43.75%. With 9 patients with EF < 53%, accounting for 18.75%. The proportion of patients who had to discontinue therapy due to cardiotoxicity during treatment with Trastuzumab was 12.5%, with 6.25% stopping completely and 6.25% of patients stopping temporarily. Conclusion: the rate of patients with heart failure was little, the proportion of EF <53% was low. The proportion of patients who had to discontinue therapy due to cardiotoxicity during treatment with Trastuzumab was low.

scholarly journals Factors Associated with “Survivor Identity” in Men with Breast Cancer

2021 ◽  
Vol 28 (3) ◽  
pp. 1696-1705
Author(s):  
Kathryn L. Dalton ◽  
Sheila N. Garland ◽  
Peggy Miller ◽  
Bret Miller ◽  
Cheri Ambrose ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Cancer Patients ◽  
Disease Type ◽  
Cancer Stage ◽  
Factors Associated ◽  
Logistic Regressions ◽  
Term Survivor ◽  
Diagnosis Age ◽  
Time Since Diagnosis

Cancer patients vary in their comfort with the label “survivor”. Here, we explore how comfortable males with breast cancer (BC) are about accepting the label cancer “survivor”. Separate univariate logistic regressions were performed to assess whether time since diagnosis, age, treatment status, and cancer stage were associated with comfort with the “survivor” label. Of the 70 males treated for BC who participated in the study, 58% moderately-to-strongly liked the term “survivor”, 26% were neutral, and 16% moderately-to-strongly disliked the term. Of the factors we explored, only a longer time since diagnosis was significantly associated with the men endorsing a survivor identity (OR = 1.02, p = 0.05). We discuss how our findings compare with literature reports on the comfort with the label “survivor” for women with BC and men with prostate cancer. Unlike males with prostate cancer, males with BC identify as “survivors” in line with women with BC. This suggests that survivor identity is more influenced by disease type and treatments received than with sex/gender identities.

scholarly journals Lesion-Based Bone Metastasis Detection in Chest Bone Scintigraphy Images of Prostate Cancer Patients Using Pre-Train, Negative Mining, and Deep Learning

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 518
Author(s):  
Da-Chuan Cheng ◽  
Te-Chun Hsieh ◽  
Kuo-Yang Yen ◽  
Chia-Hung Kao
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Deep Learning ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Bone Scintigraphy ◽  
Breast Cancer Patients ◽  
Location Detection ◽  
The Mean ◽  
Mean Sensitivity

This study aimed to explore efficient ways to diagnose bone metastasis early using bone scintigraphy images through negative mining, pre-training, the convolutional neural network, and deep learning. We studied 205 prostate cancer patients and 371 breast cancer patients and used bone scintigraphy data from breast cancer patients to pre-train a YOLO v4 with a false-positive reduction strategy. With the pre-trained model, transferred learning was applied to prostate cancer patients to build a model to detect and identify metastasis locations using bone scintigraphy. Ten-fold cross validation was conducted. The mean sensitivity and precision rates for bone metastasis location detection and classification (lesion-based) in the chests of prostate patients were 0.72 ± 0.04 and 0.90 ± 0.04, respectively. The mean sensitivity and specificity rates for bone metastasis classification (patient-based) in the chests of prostate patients were 0.94 ± 0.09 and 0.92 ± 0.09, respectively. The developed system has the potential to provide pre-diagnostic reports to aid in physicians’ final decisions.

Abstract 14922: Prognostic Value of Baseline BNP and NT-ProBNP and its Interaction With Spironolactone in Patients With Heart Failure and Preserved Ejection Fraction in the TOPCAT Trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Inder S Anand ◽  
Scott D Solomon ◽  
Brian Claggett ◽  
Sanjiv J Shah ◽  
Eileen O’Meara ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Primary Outcome ◽  
Cox Regression ◽  
Selection Criterion ◽  
Adverse Outcomes ◽  
Preserved Ejection Fraction ◽  
Patient Selection Criterion ◽  
Increased Risk ◽  
Patients With Heart Failure

Background: Plasma natriuretic peptides (NP) are helpful in the diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) and predict adverse outcomes. Levels of NP beyond a certain cut-off level are often used as inclusion criteria in clinical trials to ensure that the patients have HF, and to select patients at higher risk. Whether treatments have a differential effect on outcomes across the spectrum of NP levels is unclear. In the I-Preserve trial a benefit of irbesartan on all outcomes was only seen in HFpEF patients with low but not high NP levels. We hypothesized that in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, spironolactone might have a greater benefit in patients with lower NP levels. Methods and Results: BNP (n=468) or NT-proBNP (n=400) levels were available at baseline in 868 patients with HFpEF enrolled in the natriuretic peptide stratum (BNP ≥100 pg/mL or an NT- proBNP ≥360 pg/mL) of the TOPCAT trial. In a multi-variable Cox regression model, that included age, gender, region (Americas vs. Russia/Georgia), atrial fibrillation, diabetes, eGFR, BMI and heart rate, higher BNP or NT-proBNP as a continuous, standardized log-transformed variable or grouped by terciles (see Figure for BNP & NT-proBNP tercile values) was independently associated with an increased risk of the primary endpoint of cardiovascular mortality, aborted cardiac arrest, or hospitalization for heart failure (Figure-1). There was a significant interaction between the effect of spironolactone and baseline BNP or NT-proBNP terciles for the primary outcome (P=0.02, Figure-2), with greater benefit of the drug in the lower compared to higher NP terciles. Conclusions: The benefit of spironolactone in lower risk HFpEF patients may indicate effects of the drug on early, but not late higher-risk stage of the disease. These findings question the strategy of using elevated NP as a patient selection criterion in HFpEF trials.

Down-regulation of miR-219-5p increase the risk of cancer-related mortality in patients with prostate cancer

2021 ◽  
pp. postgradmedj-2021-139981
Author(s):  
Shimin Tang ◽  
Hao Jiang ◽  
Zhijun Cao ◽  
Qiang Zhou
Keyword(s):  
Prostate Cancer ◽  
Prediction Model ◽  
Cancer Patients ◽  
Cox Regression ◽  
Cox Model ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Risk Of Progression ◽  
Patient Prognosis ◽  
Risk Of Cancer

IntroductionProstate cancer is a common malignancy in men that is difficult to treat and carries a high risk of death. miR-219-5p is expressed in reduced amounts in many malignancies. However, the prognostic value of miR-219-5p for patients with prostate cancer remains unclear.MethodsWe retrospectively analysed data from 213 prostate cancer patients from 10 June 2012 to 9 May 2015. Overall survival was assessed by Kaplan-Meier analysis and Cox regression models. Besides, a prediction model was constructed, and calibration curves evaluated the model’s accuracy.ResultsOf the 213 patients, a total of 72 (33.8%) died and the median survival time was 60.0 months. We found by multifactorial analysis that miR-219-5p deficiency increased the risk of death by nearly fourfold (HR: 3.86, 95% CI): 2.01 to 7.44, p<0.001) and the risk of progression by twofold (HR: 2.79, 95% CI: 1.68 to 4.64, p<0.001). To quantify each covariate’s weight on prognosis, we screened variables by cox model to construct a predictive model. The Nomogram showed excellent accuracy in estimating death’s risk, with a corrected C-index of 0.778.ConclusionsmiR-219-5p can be used as a biomarker to predict death risk in prostate cancer patients. The mortality risk prediction model constructed based on miR-219-5p has good consistency and validity in assessing patient prognosis.

A heart failure care optimisation project in the north of Scotland

2020 ◽  
Vol 15 (9) ◽  
pp. 1-9
Author(s):  
Marianne O'Hara ◽  
Amanda Smith ◽  
Emma Foster ◽  
Stephen J Leslie
Keyword(s):  
Heart Failure ◽  
Medical Therapy ◽  
Real Life ◽  
Optimal Medical Therapy ◽  
Reduced Ejection Fraction ◽  
Heart Failure Care ◽  
The North ◽  
Patients With Heart Failure ◽  
Icd 10 ◽  
Project Data

Introduction: This project aimed to assess and optimise the treatment of all patients with heart failure with reduced ejection fraction (HFrEF). Methods: Consecutive patients discharged with a heart failure code (ICD-10) between April 2014 and July 2017 were included. The medical records were reviewed to ensure optimal medical therapy and in cases where this was not being received, a process of ‘active optimisation’ was initiated. Results: Out of 656 patients, 139 were identified as eligible for guideline-directed treatment, 129 (93%) of which were receiving optimal medical therapy. Of these, 47 (36%) were deemed to be optimised but were not on full guideline-directed therapy owing to contraindication, intolerance, comorbidities or non-compliance. Conclusion: The project data reflect real-world patients and practice and highlight a tension between guideline-based care and real-life (realistic) medicine.

Clinical significance of crown-like structures to trastuzumab response in patients with primary invasive HER2+ breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12533-e12533
Author(s):  
Constantinos Savva ◽  
Charles N Birts ◽  
Stéphanie A Laversin ◽  
Alicia Lefas ◽  
Jamie Krishnan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adipose Tissue ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Metabolic Reprogramming ◽  
Breast Cancer Patients ◽  
Adjuvant Trastuzumab ◽  
Her2 Breast Cancer

e12533 Background: Obesity is associated with breast cancer development and worse survival. Obesity can initiate, promote, and maintain systemic inflammation via metabolic reprogramming of macrophages that encircle adipocytes, termed crown-like structures (CLS). In breast cancer patients, CLS are present in 36-50% of patients and have been associated with anthropometric parameters. Here we focus on HER2+ breast cancer. The role of adiposity in HER2+ breast cancer is conflicting which may be attributed to the tumour heterogeneity. Adiposity has also been shown to affect the local immune environment of solid tumours. However, the prognostic significance of CLS in HER2+ breast cancer is still unknown. Methods: We investigated the prognostic significance of CLS in a cohort of 219 patients with primary HER2+ breast cancer who were diagnosed between 1982 to 2012 in Southampton General Hospital. This cohort includes 76 HER2+ trastuzumab naïve patients and 143 HER2+ patients treated with adjuvant trastuzumab. We stained FFPE tumour samples for the expression of CD68, CD16 and CD32B on CLS and correlated these to clinical outcomes. CLS were defined as CLS within distant adipose tissue, CLS within the adipose-tumour border (B-CLS) and intratumoural CLS. CLS were quantified manually in full face sections by two independent scorers and descriptive and Cox regression analysis was carried out. Results: A total of 201 tumours were suitable for CLS analyses. The median follow-up was 34.74 months (range, 0.43-299.08). In the trastuzumab naive cohort, B-CLS≤1 and B-CLS > 1 were present in 37 (52.11%) and 34 (47.89%), respectively. In the trastuzumab treated cohort, B-CLS≤1 were identified in 69 (53.08%) and B-CLS > 1 were found in 61 (46.92%) of the tumours. CLS were more commonly found in the adipose-tumour border (60.89%) rather than in the distant adipose tissue (36.14%) or intratumorally (14.36%). The presence of any CLS was significantly associated with BMI≥25 kg/m2 (p = 0.018). There was strong evidence of association between CD68+CD32B+ B-CLS and BMI≥25 kg/m2 (p = 0.007). Co-expression of CD16 and CD32B by B-CLS was more frequent in patients with BMI≥25 kg/m2 (p = 0.036). Survival analysis showed shorter time to metastatic disease in patients with CD68+ B-CLS > 1 (p = 0.011) in the trastuzumab treated cohort. Subgroup analysis revealed that in the BMI≥25 kg/m2 group, patients with CD68+ B-CLS > 1 had shorter time to metastatic disease compared to patients with B-CLS≤1 (p = 0.004). Multivariate cox regression showed that B-CLS > 1 is an independent prognostic factor for shorter time to metastatic disease in patients with primary HER2+ breast cancer that received adjuvant trastuzumab (HR 6.81, 95%CI (1.38-33.54), p = 0.018). Conclusions: B-CLS can be potentially used as a predictive biomarker to optimize the stratification and personalisation of treatment in HER2-overexpressed breast cancer patients.

Immune-related gene based prognostic signature for the risk stratification analysis of breast cancer

2021 ◽  
Vol 16 ◽  
Author(s):  
Dongqing Su ◽  
Qianzi Lu ◽  
Yi Pan ◽  
Yao Yu ◽  
Shiyuan Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Risk Score ◽  
Cox Regression ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Score Model

Background: Breast cancer has plagued women for many years and caused many deaths around the world. Method: In this study, based on the weighted correlation network analysis, univariate Cox regression analysis and least absolute shrinkage and selection operator, 12 immune-related genes were selected to construct the risk score for breast cancer patients. The multivariable Cox regression analysis, gene set enrichment analysis and nomogram were also conducted in this study. Results: Good results were obtained in the survival analysis, enrichment analysis, multivariable Cox regression analysis and immune-related feature analysis. When the risk score model was applied in 22 breast cancer cohorts, the univariate Cox regression analysis demonstrated that the risk score model was significantly associated with overall survival in most of the breast cancer cohorts. Conclusion: Based on these results, we could conclude that the proposed risk score model may be a promising method, and may improve the treatment stratification of breast cancer patients in the future work.

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