Hypertension, smoking, and preexistence of multiple cardiac risk factors correlate with carfilzomib-induced cardiovascular adverse events in a racially diverse population

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Jummai Apata¹  Farin Kamangar²  Manu Mysore³  Ethan Kotloff³  Brian Barr³  Seyed Ebrahim Kassaian⁴  Stacey Doran⁵  Ashkan Emadi⁶ 

[1] Center for Urban Health Disparities Research & Innovation, Morgan State University, Baltimore, MD, United States;Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, United States;Department of Medicine, Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, MD, United States;Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington, DC, United States;National Cancer Institute, Bethesda, MD, United States;University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, United States;Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States;Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, United States;

关键词: multiple myeloma;    carfilzomib;    cardiotoxicity;    race;    cardio-oncology;    CVAE;   

DOI  :  10.3389/fcvm.2023.1129943

 received in 2022-12-22, accepted in 2023-05-25,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundUse of the proteasome inhibitor carfilzomib has become a standard of care in patients with relapsed/refractory multiple myeloma. An association between carfilzomib and cardiovascular adverse events has been well documented, but this had not been investigated in a racially diverse population. Black patients in particular are underrepresented in the reported outcomes of treatment with carfilzomib.ObjectiveThe purpose of this study was to identify risk factors for carfilzomib-associated cardiovascular events in a diverse, single-center population.MethodsWe conducted a retrospective review of 161 patients with multiple myeloma treated with carfilzomib between 2011 and 2020 at the University of Maryland Medical Center. Over half (86) were Black patients, with the remainder (75) being White patients. We did a multivariate analysis to determine risk factors for developing cardiovascular events during treatment with carfilzomib.ResultsThere was no statistically significant association with cardiotoxicity and race, gender, or age at first dose of carfilzomib. In multivariable analysis, patients with history of hypertension had a higher risk of cardiotoxicity [adjusted odds ratio (OR): 2.5; 95% CI: 1.1–5.9; P = 0.03] as did those with a history of smoking [OR: 2.8; 95% CI: 1.3–6.4; P = 0.01].ConclusionsHere we report the largest cohort of Black patients treated with carfilzomib as yet reported. The results of this single center retrospective study show history of hypertension and smoking are associated with carfilzomib associated cardiotoxicity in a diverse patient population. There is a need for well-designed prospective studies enrolling a diverse population to investigate potential interventions to prevent carfilzomib-associated cardiotoxicity.

【 授权许可】

Unknown   
© 2023 Doran, Mysore, Kassaian, Kotloff, Kamangar, Emadi, Apata and Barr.