Survivorship clinic attendance improves completion but not timeliness of cardiac surveillance post anthracyclines.

Abstract

Background: Anthracycline induced cardiomyopathy (AIC) is an important complication of cancer management. Recent findings showed that with early identification and intervention, AIC may be fully or partially reversible. European society of cardiology (ESC) guidelines recommend a risk-stratified monitoring approach, including transthoracic echocardiogram (TTE) for all patients within 12 months post-treatment.

Aim: Investigate the impact of a survivorship clinic on TTE follow up for AIC.

Methods: Over a 5 year span, 235 patients with haematological malignancies received anthracycline chemotherapy ≥ 250mg/m². The electronic medical records of these patients were reviewed. TTE outcomes were compared between survivorship and non-survivorship patients.

Results: Survivorship patients received TTE in 88.6% of cases, whereas non-survivorship patients received TTE in 30.9% of cases. In survivorship patients, TTE was indicated for asymptomatic screening in 92.3% of cases. In non-survivorship patients the majority of TTE were for symptom investigation (78.0%). Chi-squared analysis found these results to be statistically significant (p value < 0.05).

Discussion: Survivorship patients are nearly three times more likely to receive TTE monitoring for AIC. However, due to delayed clinic referral/attendance, only 36.4% received TTE within 1 year of treatment completion, in line with ESC guidelines.

Conclusion: Survivorship clinics improve TTE monitoring for AIC, allowing early identification and potential intervention. However, reliance on this model alone may risk inadequate surveillance for patients who do not attend and delays in referral/attendance may impact monitoring timeliness.