# Primary Prevention to Reduce Cardiovascular Morbidity and Optimize Cancer Outcomes

> **NIH NIH R56** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $810,138

## Abstract

Project Summary
Our overarching goal is to identify and characterize cancer patients at risk of developing cancer treatment-
related cardiotoxicity and to mitigate cardiovascular dysfunction while optimizing cancer outcomes. Advances
in early detection and treatment of cancer has improved 5-year survival. However, multi-modal cancer
treatment often leads to cardiotoxicity. Cardiovascular disease (CVD) events during treatment can interfere
with its delivery and thus lead to sub-optimal cancer outcomes and increased downstream morbidity, cost and
mortality. American Heart Association (2019) guidelines recommend primary prevention with anti-
hyperlipidemic and anti-hypertensive medication in high risk individuals, based on atherosclerotic
cardiovascular disease (ASCVD) risk. However, it’s uncertain if primary prevention in cancer patients improves
long-term CVD outcomes. American Society of Clinical Oncology (ASCO) (2017) guidelines has categorized
high-dose anthracyclines, high dose radiation exposure to the heart, targeted therapy and certain combinations
of these, as high cardiotoxic risk regimens. The impact of primary prevention in patients on high cardiotoxic
risk regimens is unknown. ASCO guidelines also propose reduced radiation dosing, sequential treatment,
liposomal formulations, and use of dexrazoxane as cardioprotective regimen strategies, but the long-term effect
of these strategies has not been evaluated. To evaluate these questions, we will create a unique dataset by
merging Kaiser Permanente (KP)’s electronic medical records with KP’s SEER cancer registry, and Social
Security Administration (SSA)’s data, in a cohort of 25,000+ breast and lung cancer patients followed
longitudinally for 5+years. We will risk stratify breast and lung cancer patients on ASCVD risk and evaluate the
effect of primary prevention and cardioprotective regimens using advanced causal inference models exploring
treatment effect heterogeneity from policy and decision-making perspectives. The study aims are: Aim 1.
Compare effectiveness of primary prevention on 1) the incidence of CVD during cancer treatment and 2) cancer
and CVD outcomes post-treatment, in high ASCVD risk patients and high cardiotoxic risk regimens. Aim 2.
Evaluate the incremental economic impact of CVD in breast cancer and lung cancer patients & survivors and
evaluate the incremental cost and cost-effectiveness of primary prevention. Aim 3: Compare effectiveness of
cardio-protective oncology treatment strategies on 1) the incidence of CVD during cancer treatment and 2)
cancer and CVD outcomes post-treatment, in high ASCVD risk patients. Completion of this proposal will
answer the following crucial questions to improve patient outcomes (1) Does primary prevention prevent future
CVD events, improve/optimize cancer treatment and outcomes, reduce disability and cost? (2) How many
patients need to be treated to avoid one cardiovascular or cancer outcome? (2) What are the long-term effects
of primary...

## Key facts

- **NIH application ID:** 10241720
- **Project number:** 1R56HL151665-01
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Aniket A Kawatkar
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $810,138
- **Award type:** 1
- **Project period:** 2020-09-25 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241720

## Citation

> US National Institutes of Health, RePORTER application 10241720, Primary Prevention to Reduce Cardiovascular Morbidity and Optimize Cancer Outcomes (1R56HL151665-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10241720. Licensed CC0.

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