Cardiotoxicity in cancer patients treated with chemotherapy: A systematic review

The objective of the study was to assess the incidence of chemotherapy cardiotoxicity.

This is a systematic review carried out through the PubMed, VHL and Scientific Electronic Library Online databases, using the descriptors "Cardiotoxicity" and "Chemotherapy" associated with the Boolean operator "AND." Initially, 15,090 articles were found between 2015 and 2021. After applying the defined inclusion and exclusion criteria, 80 studies remained, of which 27 underwent complete reading, after which all were included in the study.

In total, 32,009 cancer patients were analyzed, of which 27,270 (85.2%) were female. Breast cancer was the most frequent neoplasm, with 11,145 (34.8%) cases. Regarding the type of chemotherapy, anthracycline was the most prevalent, analyzed in 18 (66.7%) studies, followed by trastuzumab, in 9 (33.3%) studies. Of the studies evaluated, five did not present any case of cardiotoxicity, a total of 2255 (8.3%) cases were recorded, in addition other outcomes mentioned in patients after chemotherapy were arrhythmia (n = 522), acute coronary syndrome (n = 185), diastolic dysfunction (n = 184), cardiomyopathy (n = 161), and arterial hypertension (n = 89).

Post-chemotherapeutic cardiotoxicity was mentioned in most studies, being present in a relevant percentage of the sample. Furthermore, these patients may develop other cardiovascular events.