{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:33:05Z","timestamp":1791689585362,"version":"4.3.4"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,4,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Treatment for breast cancer (BC) frequently involves radiotherapy. Guidelines recommend screening for cardiac adverse events starting 10\u2009years after radiotherapy. The rationale for this interval is unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We aimed to study cardiovascular event rates in the first decade following curative radiotherapy for BC. We compared mortality and cardiovascular event rates with an age\u2010 and risk factor\u2010matched control population. We included 1095 patients with BC (mean age 56\u00b112\u2009years). Two hundred and eighteen (19.9%) women died. Cancer and cardiovascular mortality caused 107 (49.1%) and 22 (10.1%) deaths, respectively. A total of 904 cases were matched to female FLEMENGHO (Flemish Study on Environment, Genes and Health Outcomes) participants. Coronary artery disease incidence was similar (risk ratio [RR], 0.75 [95% CI, 0.48\u20131.18]), yet heart failure (RR, 1.97 [95% CI, 1.19\u20133.25]) and atrial fibrillation\/flutter (RR, 1.82 [95% CI, 1.07\u20133.08]) occurred more often in patients with BC. Age (hazard ratio [HR], 1.033 [95% CI, 1.006\u20131.061],\n              <jats:italic>P<\/jats:italic>\n              =0.016), tumor grade (HR, 1.739 [95% CI, 1.166\u20132.591],\n              <jats:italic>P<\/jats:italic>\n              =0.007), and neoadjuvant treatment setting (HR, 2.782 [95% CI, 1.304\u20135.936],\n              <jats:italic>P<\/jats:italic>\n              =0.008) were risk factors for mortality. Risk factors for major adverse cardiac events were age (HR,\u00a01.053 [95% CI, 1.013\u20131.093];\n              <jats:italic>P<\/jats:italic>\n              =0.008), mean heart dose (HR,\u00a01.093 [95% CI, 1.025\u20131.167];\n              <jats:italic>P<\/jats:italic>\n              =0.007), history of cardiovascular disease (HR,\u00a02.386 [95% CI, 1.096\u20136.197];\n              <jats:italic>P<\/jats:italic>\n              =0.029) and Mayo Clinic Cardiotoxicity Risk Score (HR,\u00a02.664 [95% CI, 1.625\u20134.367];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ten\u2010year mortality following curative treatment for unilateral BC was mainly cancer related, but heart failure and atrial fibrillation\/flutter were already common in the first decade following irradiation. Mean heart dose, pre\u2010existing cardiovascular diseases, and Mayo Clinic Cardiotoxicity Risk Score were risk factors for cardiac adverse events. These results suggest a need for early dedicated cardio\u2010oncological follow\u2010up after radiotherapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.027855","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T10:26:25Z","timestamp":1680863185000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Mortality and Major Adverse Cardiac Events in Patients With Breast Cancer Receiving Radiotherapy: The First Decade"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2913-6297","authenticated-orcid":false,"given":"Johanna E. J.","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5612-127X","authenticated-orcid":false,"given":"Wouter","family":"L'Hoyes","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0210-1548","authenticated-orcid":false,"given":"Lieselotte","family":"Lauwens","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8255-3770","authenticated-orcid":false,"given":"Yu\u2010Ling","family":"Yu","sequence":"additional","affiliation":[{"name":"Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care University of Leuven Leuven Belgium"},{"name":"Non\u2010Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED) Mechelen Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Brusselmans","sequence":"additional","affiliation":[{"name":"Leuven Biostatistics and Statistical Bioinformatics Centre (L\u2010Biostat) Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-7151","authenticated-orcid":false,"given":"Caroline","family":"Weltens","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0575-1888","authenticated-orcid":false,"given":"Jens\u2010Uwe","family":"Voigt","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-7837","authenticated-orcid":false,"given":"Hans","family":"Wildiers","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1434-9460","authenticated-orcid":false,"given":"Patrick","family":"Neven","sequence":"additional","affiliation":[{"name":"Department of Gynaecology University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6675-4559","authenticated-orcid":false,"given":"Joerg","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8108-2356","authenticated-orcid":false,"given":"Lutgarde","family":"Thijs","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3026-1637","authenticated-orcid":false,"given":"Jan A.","family":"Staessen","sequence":"additional","affiliation":[{"name":"Non\u2010Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED) Mechelen Belgium"},{"name":"Biomedical Science Group, Faculty of Medicine University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3609-1122","authenticated-orcid":false,"given":"Stefan","family":"Janssens","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals (UZ) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7252-5162","authenticated-orcid":false,"given":"Lucas N. 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