Examining Factors Associated with Experiencing Cardiac Arrhythmias in Black and White Breast Cancer Survivors Who Received Anthracyclines or Trastuzumab

Purpose : Racial disparities exist regarding cardiovascular (CV) toxicities following breast cancer treatment; however, studies on racial differences in cardiac arrhythmias are lacking. This study examined associations between demographic and clinical factors and arrhythmia diagnosis in Black and White breast cancer survivors. Methods : This study included a retrospective cohort of Black and White women who were diagnosed with breast cancer and who received potentially cardiotoxic treatment. Cardiac arrhythmia data were captured via International Classification of Diseases, Tenth and Ninth Versions (ICD-10 and ICD-9). Experiences with cardiac arrhythmias were compared across racial groups. The associations of demographic and clinical factors with cardiac arrhythmias were evaluated using logistic regression for all women and in race-stratified models. Results : Cardiac arrhythmias were experienced by 33% of the total 860 women (mean (SD) age 50.3 [10.7] years). In bivariate analyses, Black women were more likely to experience arrhythmias when compared to White women (p=0.006). In race-stratified multivariable analysis, controlling for age and treatment, Black women >50 years were less likely to experience arrhythmias when compared to Black women < 50 (adjusted odds ratio (OR): 0.50; 95% confidence interval [CI]: 0.29, 0.87) years. Black women with hypertension were 2.7 times more likely to experience arrhythmias than Black women without hypertension [95% CI: 1.52, 4.82]. White women with obesity were more likely to experience arrhythmias than White women with normal/underweight (OR: 1.97: [1.18, 3.28]). Conclusion : Survivors with chronic conditions like hypertension and obesity may require enhanced cardiac surveillance. Further investigation into hypertension management in Black survivors may shed light on its impact on CV toxicities in this group.