Τίτλος:
Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: The CARDIOTOX registry
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: Cardiotoxicity (CTox) is a major side effect of cancer therapies, but uniform diagnostic criteria to guide clinical and research practices are lacking. Methods and results: We prospectively studied 865 patients, aged 54.7 ± 13.9; 16.3% men, scheduled for anticancer therapy related with moderate/high CTox risk. Four groups of progressive myocardial damage/dysfunction were considered according to current guidelines: normal, normal biomarkers (high-sensitivity troponin T and N-Terminal natriuretic pro-peptide), and left ventricular (LV) function; mild, abnormal biomarkers, and/or LV dysfunction (LVD) maintaining an LV ejection fraction (LVEF) ≥50%; moderate, LVD with LVEF 40-49%; and severe, LVD with LVEF ≤40% or symptomatic heart failure. Cardiotoxicity was defined as new or worsening of myocardial damage/ventricular function from baseline during follow-up. Patients were followed for a median of 24 months. Cardiotoxicity was identified in 37.5% patients during follow-up [95% confidence interval (CI) 34.22-40.8%], 31.6% with mild, 2.8% moderate, and 3.1% with severe myocardial damage/dysfunction. The mortality rate in the severe CTox group was 22.9 deaths per 100 patients-year vs. 2.3 deaths per 100 patients-year in the rest of groups, hazard ratio of 10.2 (95% CI 5.5-19.2) (P < 0.001). Conclusions: The majority of patients present objective data of myocardial injury/dysfunction during or after cancer therapy. Nevertheless, severe CTox, with a strong prognostic relationship, was comparatively rare. This should be reflected in protocols for clinical and research practices. © 2020 Published on behalf of the European Society of Cardiology. All rights reserved.
Συγγραφείς:
López-Sendón, J.
Álvarez-Ortega, C.
Zamora Auñon, P.
Buño Soto, A.
Lyon, A.R.
Farmakis, D.
Cardinale, D.
Canales Albendea, M.
Feliu Batlle, J.
Rodríguez Rodríguez, I.
Rodríguez Fraga, O.
Albaladejo, A.
Mediavilla, G.
González-Juanatey, J.R.
Martínez Monzonis, A.
Gómez Prieto, P.
González-Costello, J.
Serrano Antolín, J.M.
Cadenas Chamorro, R.
López Fernández, T.
Περιοδικό:
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
aldosterone antagonist; amino terminal pro brain natriuretic peptide; angiotensin receptor antagonist; anthracycline; antineoplastic agent; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; ivabradine; protein tyrosine kinase inhibitor; troponin T, adult; Article; biochemical analysis; cancer chemotherapy; cancer patient; cancer radiotherapy; cardiotoxicity; cardiovascular parameters; clinical outcome; controlled study; disease classification; disease exacerbation; disease marker; disease registry; disease severity; dyslipidemia; echocardiography; female; follow up; hazard ratio; heart failure; heart left ventricle ejection fraction; heart left ventricle failure; heart left ventricle function; high risk patient; human; major clinical study; male; malignant neoplasm; mediastinum; medical history; middle aged; mortality; mortality rate; patient selection; practice guideline; prevalence; priority journal; prospective study; radiological parameters; aged; epidemiology; heart left ventricle function; heart stroke volume; prevalence; register, Adult; Aged; Female; Humans; Male; Middle Aged; Prevalence; Registries; Stroke Volume; Ventricular Dysfunction, Left; Ventricular Function, Left
DOI:
10.1093/eurheartj/ehaa006
