Impact of Pre-Existing Cardiovascular and Metabolic Conditions on the Development of Heart Failure After Paclitaxel Therapy: Real-World Study Based on a Nationwide Claims Database in Japan.

Background: The early detection and treatment of cancer have led to an aging population of cancer survivors, and mortality rates from cardiovascular diseases are increasing. The incidence of heart failure (HF) after treatment with paclitaxel (PTX), a microtubule polymerization promoter and cardiotoxic anticancer agent, is low and the risk factors for post-PTX HF remain unclear. A history of heart disease has been suggested as a potential cardiovascular risk factor in cancer survivors. Using the JMDC database of real-world medical data in Japan, we investigated whether heart and lifestyle-related diseases affect the onset of HF after PTX treatment. Methods and Results: Patients who underwent PTX treatment were identified in the JMDC database, and the occurrence of HF was determined to analyze associations between heart- and lifestyle-related diseases and the occurrence of HF after PTX administration. Of the patients who received PTX, 17.7% developed HF. The results of multivariable Cox proportional hazards analysis indicated that comorbidities such as ischemic heart disease, atrial fibrillation, pericarditis, pulmonary embolism, and hypertension were associated with the onset of HF in patients receiving PTX. Conclusions: Although the incidence of HF after PTX administration is not high, patients with specific medical histories or comorbidities may be at increased risk, and careful monitoring is warranted to detect potential cardiovascular complications.