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. 2021 Jun 29:13:5149-5159.
doi: 10.2147/CMAR.S313874. eCollection 2021.

Cardiotoxicity and Cardiac Monitoring Among Anthracycline-Treated Cancer Patients: A Retrospective Cohort Study

Hadeel Alkofide  1 , Lamya Alnaim  1 , Nora Alorf  2 , Ward Alessa  2 , Ghada Bawazeer  1
Affiliations

Cardiotoxicity and Cardiac Monitoring Among Anthracycline-Treated Cancer Patients: A Retrospective Cohort Study

Hadeel Alkofide et al. Cancer Manag Res. .

Abstract

Purpose: Cardiotoxicity is a common complication associated with anthracyclines. Little is known regarding the rate of anthracyclines-related acute and chronic cardiotoxicity and adherence to cardiac monitoring recommendations among cancer patients.

Patients and methods: A single-centre retrospective cohort study was conducted from 2015 to 2018 on patients with cancer, 18 years of age and older, on anthracyclines without a history of cardiovascular diseases. Data on demographic information, comorbidities, cardiovascular events, monitoring parameters, and treatment details were obtained. The primary outcome was the incidence of anthracyclines-related cardiotoxicity both acute and chronic. The secondary outcome was to determine adherence to guideline recommendations for monitoring anthracyclines-related cardiotoxicity based on the American Society of Clinical Oncology clinical practice guidelines. Analyses included descriptive statistics and logistic regression. Institutional review board approval was obtained.

Results: In 235 patients identified, 28.9% developed cardiotoxicity, of which 27.2% were acute, while chronic cardiotoxicity was observed in 8.9% of subjects. Patients who received optimal cardiac monitoring had a statistically significant higher odds of developing cardiotoxicities (odds ratio=2.65, confidence interval=1.32-5.33). The risk of cardiotoxicity was higher in subjects with a history of diabetes mellitus, those using daunorubicin, and concomitant filgrastim use. Adherence to guideline recommendations was only achieved in 25.1% of the population. Echocardiography was the most common monitoring method used.

Conclusion: In this study, there was a high incidence of anthracyclines cardiotoxicity and poor compliance with cardiac monitoring recommendations for cancer patients on anthracyclines, which underscores acute and chronic cardiotoxicity in this population.

Keywords: anthracyclines; anthracyclines-induced cardiotoxicity; cancer; cardiac monitoring.

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Conflict of interest statement

The abstract of this paper was presented at the 9th college of pharmacy research day (COPRD) at King Saud University, College of Pharmacy, as a presentation with interim findings. The authors report no conflicts of interest in this work.

References

    1. Hortobágyi GN. Anthracyclines in the treatment of cancer. An overview. Drugs. 1997;54(Suppl 4):1–7. doi:10.2165/00003495-199700544-00003 - DOI - PubMed
    1. Smith LA, Cornelius VR, Plummer CJ, et al. Cardiotoxicity of anthracycline agents for the treatment of cancer: systematic review and meta-analysis of randomised controlled trials. BMC Cancer. 2010;10:337. doi:10.1186/1471-2407-10-337 - DOI - PMC - PubMed
    1. Livshits Z, Rao RB, Smith SW. An approach to chemotherapy-associated toxicity. Emerg Med Clin North Am. 2014;32(1):167–203. doi:10.1016/j.emc.2013.09.002 - DOI - PubMed
    1. Leong SL, Chaiyakunapruk N, Lee SWH. Antineoplastic-related cardiovascular toxicity: a systematic review and meta-analysis in Asia. Crit Rev Oncol Hematol. 2019;141:95–101. doi:10.1016/j.critrevonc.2019.05.017 - DOI - PubMed
    1. Simůnek T, Stérba M, Popelová O, Adamcová M, Hrdina R, Gersl V. Anthracycline-induced cardiotoxicity: overview of studies examining the roles of oxidative stress and free cellular iron. Pharmacol Rep. 2009;61(1):154–171. doi:10.1016/S1734-1140(09)70018-0 - DOI - PubMed