Estimating Causal Effects Of Relapse Treatment On The Risk For Acute Myocardial Infarction Among Patients With Diffuse Large B-Cell Lymphoma

Abstract: This empirical register study intends to estimate average causal effects of relapse treatment on the risk for acute myocardial infarction (AMI) among patients with Diffuse B-Cell Lymphoma (DLBCL) within the potential outcome framework. The report includes a brief introduction to causal inference and survival anal- ysis and mentions specific causal parameters of interest that will be estimated. A cohort of 2887 Swedish DLBCL patients between 2007 and 2014 were included in the study where 560 patients suffered a relapse. The relapse treatment is hypothesised to be cardiotoxic and induces an increased risk of heart diseases. The identifiability assumptions need to hold to estimate average causal effects and are assessed in this report. The patient cohort is weighted using inverse probability of treatment and censoring weights and potential marginal survival curves are estimated from marginal structural Cox models. The resulting point estimate indicates a protective causal effect of relapse treatment on AMI but estimated bootstrap confidence intervals suggest no significant effect on the 5% significance level.