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Table 3 Hazard ratios from cause-specific and subdistribution hazard models for predictors of AET discontinuation, death and cancer recurrence

From: Are breast cancer patients with suboptimal adherence to cardiovascular treatment more likely to discontinue adjuvant endocrine therapy? Competing risk survival analysis in a nationwide cohort of postmenopausal women

Predictors (adjusted)

Cause-specific Cox model

Fine-and-Gray subdistribution model

AET discontinuation

Death

Cancer recurrence

AET discontinuation

CSHRa [95% CI]

CSHR [95% CI]

CSHR [95% CI]

SDHRb [95% CI]

Global cardiovascular adherencec

    

 Total adherence

Ref

Ref

Ref

Ref

 Partial adherence

1.16 [1.10; 1.22]***

0.96 [0.84; 1.11]

1.05 [0.97; 1.13]

1.15 [1.10; 1.21]***

 Total non-adherence

1.49 [1.39; 1.58]***

1.17 [0.96; 1.42]

0.98 [0.88; 1.08]

1.47 [1.38; 1.57]***

Age at baseline

    

 50–70

Ref

Ref

Ref

Ref

 71–75

1.20 [1.13; 1.27] ***

1.69 [1.37; 2.09]***

1.02 [0.93; 1.12]

1.18 [1.11; 1.25]***

 76–80

1.44 [1.35; 1.53] ***

2.31 [1.86; 2.86]***

1.38 [1.24; 1.52]***

1.39 [1.30; 1.48]***

 > 80

1.90 [1.79; 2.02] ***

6.60 [5.52; 7.90]***

1.78 [1.60; 1.98]***

1.77 [1.66; 1.88]***

Type of BC surgery

    

 Tumorectomy

Ref

Ref

Ref

Ref

 Total mastectomy

1.03 [0.98; 1.08]

1.51 [1.32; 1.72]***

1.21 [1.12; 1.30]***

1.01 [0.96; 1.06]

Adjuvant chemotherapy in the year before AET

    

 No

Ref

Ref

Ref

Ref

 Yes

0.92 [0.87; 0.98] **

0.80 [0.66; 0.98]**

5.58 [5.17; 6.03]***

0.80 [0.75; 0.84]***

Number of prescribed cardiovascular drug classes

    

 2

Ref

Ref

Ref

Ref

 3

1.04 [0.99; 1.09]

1.26 [1.09; 1.46]***

0.96 [0.89; 1.04]

1.04 [0.99; 1.09]

 4

1.07 [1.00; 1.15]*

1.39 [1.16; 1.68]***

0.93 [0.83; 1.04]

1.07 [0.99; 1.14]

 5–6

1.13 [1.01; 1.27]*

1.57 [1.19; 2.06]***

0.99 [0.82; 1.19]

1.12 [1.00; 1.26]*

Time since initiation of any cardiovascular treatment

    

 < 5 years

Ref

Ref

Ref

Ref

 ≥ 5 years

0.58 [0.54; 0.61] ***

1.17 [0.95; 1.43]

1.00 [0.91; 1.11]

0.57 [0.54; 0.61]***

AET drug switch

    

 0

Ref

Ref

Ref

Ref

 1

1.79 [1.69; 1.91]***

0.98 [0.81; 1.18]

0.81 [0.72; 0.92]***

1.88 [1.76; 2.00]***

 ≥ 2

2.57 [2.37; 2.78]***

0.65 [0.47; 0.89]**

1.15 [0.97; 1.36]

2.75 [2.53; 2.99]***

Number of comorbidities (besides BC and CV risk)

    

 0

Ref

Ref

Ref

Ref

 1

1.17 [1.11; 1.23]***

1.43 [1.20; 1.69]***

0.99 [0.91; 1.07]

1.16 [1.10; 1.22]***

 ≥ 2

1.23 [1.16; 1.30]***

2.66 [2.26; 3.14]***

1.11 [1.02; 1.21]*

1.20 [1.13; 1.27]***

Number of hospital stays in the year before AET

    

 0

Ref

Ref

Ref

Ref

 1

1.05 [0.98; 1.11]

1.30 [1.10; 1.53]**

1.14 [1.04; 1.24]**

1.03 [0.97; 1.10]

 ≥ 2

1.12 [1.02; 1.23]*

1.69 [1.35; 2.12]***

1.20 [1.07; 1.36]*

1.09 [1.00; 1.20]

FDEPd

    

 Q1

1.13 [1.06; 1.21]***

0.85 [0.69; 1.04]

0.90 [0.81; 1.01]

1.14 [1.06; 1.22]***

 Q2

1.10 [1.03; 1.18]**

0.84 [0.69; 1.02]

0.99 [0.89; 1.09]

1.11 [1.04; 1.19]**

 Q3

1.07 [1.00; 1.15]*

0.97 [0.80; 1.16]

0.90 [0.81; 1.00]*

1.08 [1.01; 1.16]*

 Q4

1.04 [0.97; 1.11]

0.92 [0.77; 1.10]

0.90 [0.81; 1.00]*

1.05 [0.98; 1.12]

 Q5

Ref

Ref

Ref

Ref

Financial aid for complementary health insurance

    

 No

Ref

Ref

Ref

Ref

 Yes

1.07 [0.95; 1.20]

1.48 [1.08; 2.01]**

0.97 [0.81; 1.16]

1.07 [0.95; 1.20]

  1. Abbreviations: BC breast cancer, AET adjuvant endocrine therapy, CSHR cause-specific hazard ratio, SDHR subdistribution hazard ratio
  2. aCause-specific hazard ratios are interpreted as the adjusted effect of the covariate on the instantaneous rate of AET discontinuation among women currently event-free, that is who have not discontinued AET, died or experienced cancer recurrence up to time t
  3. bSubdistribution hazard ratios are interpreted as the impact of a given covariate on the cumulative incidence of AET, that is on the probability that AET discontinuation occurred in the population by time t
  4. cPatients were classified as fully adherence, partially adherent or fully non-adherent if they adhered to all, some or none of their cardiovascular drugs
  5. dThe FDEP is a French index of social deprivation that summarises median household income, percentage of high school graduates in the population aged over 15, percentage of blue-collar workers in the active population and unemployment rate. Q1 is the least deprived quintile
  6. *p ≤ 0.05
  7. **p ≤ 0.01
  8. ***p ≤ 0.001
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