title: Incidence and Risk of Cardiac Events in Patients With Previously Treated Multiple Myeloma Versus Matched Patients Without Multiple Myeloma: An Observational, Retrospective, Cohort Study.
abstract: Multiple myeloma (MM) patients have age-, disease-, and treatment-related risk factors for cardiac events.
  
  
  
  We analyzed the 2006 to 2011 MarketScan database to determine whether the risk of cardiac events is greater in MM patients than in non-MM patients. Included were 1723 MM patients treated with corticosteroids and ≥ 3 drugs (bortezomib, immunomodulatory derivatives, and alkylating agents or anthracyclines). The index date (ID) was the date on which the 3-drug exposure criterion was met. Also included were 8615 age- and gender-matched non-MM patients (5:1). The distribution of non-MM patients' IDs matched that of the MM patients' IDs. Baseline was 6 months before the ID. The follow-up duration was from the ID to study end (ie, 2011 or end of enrollment or prescription drug coverage). Hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for baseline variables when the univariate analyses showed a 10% difference.
  
  
  
  The median duration of observation was 9 months (range, 0-60 months) for MM patients and 19 months (range, 0-66 months) for non-MM patients. The risk of any cardiac event (HR, 2.2; 95% CI, 1.9-2.5), dysrhythmia (HR, 4.1; 95% CI, 3.5-4.8), congestive heart failure (HR, 2.9; 95% CI, 2.2-3.7), cardiomyopathy (HR, 2.6; 95% CI, 1.8-3.8), and conduction disorders (HR, 1.7; 95% CI, 1.2-2.5) was significantly greater for MM than for non-MM patients. The incidence of hypertensive or arterial events and ischemic heart disease was similar between the 2 groups.
  
  
  
  The present study provides the first known comparison of cardiac event risk in patients with MM versus age- and gender-matched patients without MM. The cardiac event risk was greater in MM patients with ≥ 3 previous drugs for any cardiac event, dysrhythmias, congestive heart failure, cardiomyopathy, and conduction disorders compared with patients without MM.
authors.affiliation: Evidera, Waltham, MA. Electronic address: Kristin.kistler@evidera.com.
authors.forename: Kristin D
authors.initials: KD
authors.lastname: Kistler
authors.affiliation: North Shore-Long Island Jewish Health System, Lenox Hill Hospital, New York, NY.
authors.forename: Jill
authors.initials: J
authors.lastname: Kalman
authors.affiliation: Mount Sinai School of Medicine, New York, NY.
authors.forename: Gagan
authors.initials: G
authors.lastname: Sahni
authors.affiliation: Evidera, Waltham, MA.
authors.forename: Brian
authors.initials: B
authors.lastname: Murphy
authors.affiliation: Onyx Pharmaceuticals, Inc, an Amgen Subsidiary, South San Francisco, CA.
authors.forename: Winifred
authors.initials: W
authors.lastname: Werther
authors.affiliation: Cleave Biosciences, Inc, Burlingame, CA.
authors.forename: Kanya
authors.initials: K
authors.lastname: Rajangam
authors.affiliation: Mount Sinai School of Medicine, New York, NY.
authors.forename: Ajai
authors.initials: A
authors.lastname: Chari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Anti-MM treatment; Cardiotoxicity; Database analysis; Refractory; Relapsed