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Risk Factors for Anthracycline-Induced Cardiotoxicity
Shuo Qiu1, Tian Zhou1, Bo Qiu2
1Department of Ultrasound Diagnostics, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Frontiers in Cardiovascular Medicine
|October 18, 2021
Summary
Hypertension, diabetes, and obesity increase the risk of anthracycline-induced cardiotoxicity. Global longitudinal strain (GLS) offers superior early detection of this cardiotoxicity compared to left ventricular ejection fraction (LVEF).
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Cardiovascular risk factors' role in anthracycline-induced cardiotoxicity lacks consensus.
- Anthracycline chemotherapy, excluding trastuzumab, is a focus for cardiotoxicity studies.
- Defining cardiotoxicity requires standardized metrics for accurate assessment.
Approach:
- A meta-analysis of studies from PubMed, EMBASE, and Cochrane Library (inception to Feb 2021) was conducted.
- Included 7,488 patients receiving anthracycline chemotherapy without trastuzumab, assessing baseline risk factors.
- Cardiotoxicity was defined by left ventricular ejection fraction (LVEF) reduction; odds ratios (OR) and confidence intervals (CI) were calculated.
Key Points:
- Hypertension (OR: 1.99), diabetes mellitus (OR: 1.74), and obesity (OR: 1.72) significantly increased cardiotoxicity risk.
- Global longitudinal strain (GLS) demonstrated a higher detection rate (28.5%) versus LVEF (16.4%) for cardiotoxicity.
- GLS showed improved early detection of cardiotoxicity (30.2% at 3 months) compared to LVEF.
Conclusions:
- Hypertension, diabetes mellitus, and obesity are confirmed risk factors for anthracycline-induced cardiotoxicity.
- Proactive protective strategies are recommended during and after anthracycline treatment for at-risk patients.
- GLS offers advantages over LVEF for detecting and monitoring anthracycline-induced cardiotoxicity.
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