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

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.

Racial and Ethnic Differences in Cardiac Surveillance Evaluation of Patients Treated With Anthracycline‐Based Chemotherapy

“…The emergence of data reporting that less than half of patients receiving anthracyclines undergo recommended surveillance is clearly unacceptable. 26 , 27 Clearly, our findings identify a key opportunity to improve the cancer care continuum that could lead to better cancer survivorship. Social disparities in short‐ and long‐term cancer care are well known for NHB and Hispanic populations.…”

“…Patients were more likely (OR, 2.6 [95% CI, −1.32 to 5.33]) to develop cardiotoxicity with optimal cardiac monitoring. 26 Early identification of patients who develop a reduction in LVEF presents an opportunity to prescribe appropriate medical therapy and potentially lead to full cardiac recovery. 27 , 28 We hope that our findings can foster additional efforts in cardiac surveillance for all racial and ethnic groups.…”

A first approach to identifying cardiotoxic effects of breast cancer chemotherapeutic treatment in Kazakhstan

“…Although the frequency of the chemotherapy cardiotoxic effects depends mainly on the class of drugs prescribed, there are other predisposing factors. Reportedly, the incidence of cardiotoxicity among Anthracyclines ranges from 8.9% (chronic) up to 27.2% (acute); however, the incidence is based on the cumulative dose and other risk factors, such as poor compliance with cardiac monitoring recommendations [20]. According to leading Italian experts (ICOS-ONE Study Investigators), the incidence of Anthracycline-induced cardiac events was 1.1% within the sample of N 273 [21].…”

A Methodological Review of Drug-Related Toxicological Studies in Saudi Arabia

“…Most studies included both men and women, except two studies that included only women. Out of 30 studies, four studies were aimed to explore drug-related hospitalizations [ 3 , 32 , 35 , 38 ], eight studies explored the adverse drug reactions [ 14 , 15 , 17 , 21 , 33 , 37 , 40 , 42 ], three studies explored drug-induced cardiotoxicity [ 16 , 24 , 27 ], four studies explored drug-induced nephrotoxicity [ 19 , 23 , 30 , 31 ], one study explored drug-induced pulmonary toxicity [ 26 ], one study explored drug-induced retinal toxicity [ 20 ], eight studies explored poisoning [ 18 , 22 , 25 , 28 , 29 , 34 , 39 , 41 ], and one study explored drug overdose [ 36 ]. Full details about the included studies are available in Table 1 .…”