The date of the cancer confirmatory diagnosis visit was considered the study entry date. Baseline characteristics were assessed at this time and during echocardiographic data collection precluding cancer treatment. These included age, socioeconomic characteristics, comorbidities, medications, family history of cardiovascular disease, smoking status, and body measurements. Socioeconomic characteristics of interest were white race, marital status, ZIP code, and county of residence. The latter was used through aggregated census data per “neighborhood” to estimate patient income and education level (21). Comorbidities of interest were hypertension, diabetes, cardiovascular disease, CAD, chronic obstructive pulmonary disease, cardiac dysrhythmias, depression, overweight or obesity, and Charlson score. We identified the use of statins, ACE inhibitors, beta-blockers, and insulin at or before the study entry date. Body measures consisted of body mass index, systolic and diastolic blood pressure, baseline heart rate, ejection fraction, left ventricular systolic and diastolic dysfunction, low-density lipoprotein, and cholesterol. A composite variable of cardiac risk factors for cardiotoxicity was derived from baseline characteristics and considered positive for subjects age <55 years who had ≥1 of the following: hypertension, history of smoking, family history of cardiovascular conditions, CAD, and/or low-density lipoprotein >100 mg/dl.