Cardiac Arrhythmia Risk after Anti-Cancer Drug Exposure and Related Disease Molecular Imaging Outlook: A Systematic...

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Chemotherapy, a primary cancer treatment, carries risks of adverse reactions.
• The association between anthracyclines and increased arrhythmia risk is debated.
• Systemic drug side effects can impact patient prognosis.

Purpose of the Study:

• To systematically evaluate the overall and drug-specific arrhythmic risk associated with anthracyclines.
• To conduct a meta-analysis and network meta-analysis to compare risks.

Main Methods:

• Searched PubMed, Web of Science, EMBASE, and Cochrane Library up to March 2022.
• Included randomized controlled trials, cohort studies, and case-control studies.
• Utilized PRISMA 2020 guidelines and frequentist methods for meta-analyses.

Main Results:

• Anthracyclines use increased arrhythmia risk by 90% (OR 1.90) and supraventricular arrhythmia risk by 114% (OR 2.14).
• Single-arm studies indicated a 20% incidence of arrhythmia.
• Epirubicin demonstrated the highest arrhythmia risk (OR 43.07) compared to non-anthracycline drugs.

Conclusions:

• Anthracyclines are linked to a significant increase in arrhythmia, especially supraventricular types.
• Epirubicin presents the highest risk, underscoring the need for cardiac monitoring.
• Future research should explore therapies for anthracycline-associated arrhythmia and utilize molecular imaging to understand drug mechanisms.