Predictors of early cardiotoxicity during breast cancer chemotherapy with doxorubicin in patients at average and low risk according to the HFA-ICOS assessment
Abstract
Objective. To study the association of arterial hypertension (AH), body mass index (BMI) >30 kg/m2, smoking, age over 65 years, cardiac troponin levels (cTnI and cTnT) and NT-proBNP levels with the risk of early cardiotoxicity (CT) in patients with established breast cancer receiving doxorubicin therapy.
Materials and methods. The study included 100 patients (breast cancer) from the medium and low risk group according to HFA-ICOS. CT criterion is a relative reduction in global longitudinal myocardial strain of more than 12 %, echocardiography method.
Results. It was revealed that the frequency of occurrence of the factor smoking is statistically significantly higher in the CT+ subgroup and its presence is associated with the risk of developing CT after the end of chemotherapy, OR 4,14 (95 % CI (1,3–12,9)). No relationship was found between CT and hypertension, BMI > 30 kg/m2, age over 65 years, cTnI, cTnI and NT-proBNP levels after the end of chemotherapy. Hypertension was statistically significantly more common (p < 0,05) among patients with preserved early CT signs after 12 months OR 6,8 (95 % CI (0,6–71,2)). Statistically significant differences between the percentage of patients with and without a risk factor for smoking (p < 0,05) OR 3,3 (95 % CI (0,9–11,6)) were observed 12 months after chemotherapy.
Conclusion. It has been established that smoking is associated with the development of early CT during chemotherapy with doxorubicin in patients from low and intermediate risk groups (HFA-ICOS). This factor can be used to predict the risk of developing CT after and 12 months after the end of chemotherapy. At the same time, hypertension is not associated with the development of early CT at the stage after and 12 months after the end of chemotherapy, however, it can be used as a predictor of prolongation of CT after 12 months, when the primary CT was diagnosed immediately after the end of chemotherapy.
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For citations:
Karputs I.A. Predictors of early cardiotoxicity during breast cancer chemotherapy with doxorubicin in patients at average and low risk according to the HFA-ICOS assessment. Healthcare. 2024;(7):44-50. (In Russ.)
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