https://doi.org/10.4081/monaldi.2023.2514
Cardiovascular toxicity in breast cancer patients – contributors and role of cardioprotective drugs
Submitted: December 30, 2022
Accepted: January 30, 2023
Published: March 28, 2023
Accepted: January 30, 2023
Abstract Views: 1206
PDF: 282
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Breast cancer (BC) patients treated with anthracyclines and/or anti-HER2-targeted therapies (AHT) are highly associated with cardiovascular toxicity (CVT). Our objective was to evaluate the risk of CVT secondary to cancer treatment and the role of cardioprotective-drugs (CPD) in BC patients. We collected a retrospective cohort of females with BC treated with chemotherapy and/or AHT from 2017 to 2019. CVT was defined as LVEF<50% or decline ≥10% during follow-up. As CPD, we considered renin-angiotensin-aldosterone-system inhibitors and beta-blockers. A subgroup analysis of the AHT patients was also performed. A total of 203 women were enrolled. The majority had high or very-high CVT risk score and normal cardiac function at presentation. As for CPD, 35.5% were medicated pre-chemotherapy. All patients were submitted to chemotherapy; AHT were applied to 41.7%. During a 16 months follow-up, 8.5% developed CVT. There was a significant decrease of GLS and LVEF at 12-months (decrease of 1.1% and 2.2%, p<0.001). AHT and combined therapy were significantly associated with CVT. In the AHT sub-group analysis (n=85), 15.7% developed CVT. Patients previously medicated with CPD had a significative lower incidence of CVT (2.9% vs 25.0%, p=0.006). Patients already on CPD presented a higher LVEF at 6-months follow-up (62.5% vs 59.2%, p=0.017). Patients submitted to AHT and anthracycline therapy had higher risk of developing CVT. In the AHT sub-group, pre-treatment with CPD was significantly associated with a lower prevalence of CVT. These results highlight the importance of cardio-oncology evaluation and strengthen the value of primary prevention.
World Health Organization International Agency for Research on Cancer (IARC). GLOBOCAN 2020: estimated cancer incidence, mortality and prevalence worldwide in 2020. 2020. Accessed 2022 Jul 23. Available from: https://gco.iarc.fr/today/fact-sheets-cancers
Naaktgeboren WR, Linschoten M, de Graeff A, et al. Long-term cardiovascular health in adult cancer survivors. Maturitas 2017;105:37-45.
DOI: https://doi.org/10.1016/j.maturitas.2017.05.014
Pondé NF, Lambertini M, de Azambuja E. Twenty years of anti-HER2 therapy-associated cardiotoxicity. ESMO Open 2016;1:e000073.
DOI: https://doi.org/10.1136/esmoopen-2016-000073
Slamon D, Eiermann W, Robert N, et al. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med 2011;365:1273-83.
DOI: https://doi.org/10.1056/NEJMoa0910383
Yu AF, Yadav NU, Lung BY, et al. Trastuzumab interruption and treatment-induced cardiotoxicity in early HER2-positive breast cancer. Breast Cancer Res Treat 2015;149:489-95.
DOI: https://doi.org/10.1007/s10549-014-3253-7
Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 2005;353:1659-72.
DOI: https://doi.org/10.1056/NEJMoa052306
Yamaguchi N, Fujii T, Aoi S, et al. Comparison of cardiac events associated with liposomal doxorubicin, epirubicin and doxorubicin in breast cancer: a Bayesian network meta-analysis. Eur J Cancer 2015;51:2314-20.
DOI: https://doi.org/10.1016/j.ejca.2015.07.031
Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J 2016;37:2768-801.
DOI: https://doi.org/10.1093/eurheartj/ehw211
Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022;43:4229-61.
DOI: https://doi.org/10.1093/eurheartj/ehac244
Cardinale D, Colombo A, Bacchiani G, et al. Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation 2015;131:1981-8.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.114.013777
Barros-Gomes S, Herrmann J, Mulvagh SL, et al. Rationale for setting up a cardio-oncology unit: our experience at Mayo Clinic. Cardiooncology 2016;2:5.
DOI: https://doi.org/10.1186/s40959-016-0014-2
Čelutkienė J, Pudil R, López-Fernández T, et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC). Eur J Heart Fail 2020;22:1504-24.
DOI: https://doi.org/10.1002/ejhf.1957
Plana JC, Galderisi M, Barac A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imag 2014;15:1063-93.
DOI: https://doi.org/10.1093/ehjci/jeu192
Martins de Carvalho M SC. Cardio-oncology: the future is now! Rev Port Cardiol 2022;41:985-6.
DOI: https://doi.org/10.1016/j.repc.2022.08.005
Čelutkienė J, Plymen CM, Flachskampf FA, et al. Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2018;20:1615-33.
DOI: https://doi.org/10.1002/ejhf.1330
Caspani F, Tralongo AC, Campiotti L, et al. Prevention of anthracycline-induced cardiotoxicity: a systematic review and meta-analysis. Intern Emerg Med 2021;16:477-86.
DOI: https://doi.org/10.1007/s11739-020-02508-8
Vaduganathan M, Hirji SA, Qamar A, et al. Efficacy of neurohormonal therapies in preventing cardiotoxicity in patients with cancer undergoing chemotherapy. JACC CardioOncol 2019;1:54-65.
DOI: https://doi.org/10.1016/j.jaccao.2019.08.006
Fang K, Zhang Y, Liu W, et al. Effects of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use on cancer therapy-related cardiac dysfunction: a meta-analysis of randomized controlled trials. Heart Fail Rev 2021;26:101-9.
DOI: https://doi.org/10.1007/s10741-019-09906-x
Pinho JF, Nunes JP, Paiva M, et al. Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? - A Systematic review and meta-analysis. Port Cardiol 2023. Online Ahead of Print.
DOI: https://doi.org/10.1016/j.repc.2022.10.016
How to Cite
Martins Carvalho, Miguel, Ricardo Alves Pinto, Tânia Proença, Inês Costa, Nuno Tavares, Mariana Paiva, Carla Sousa, and Filipe Macedo. 2023. “Cardiovascular Toxicity in Breast Cancer Patients – Contributors and Role of Cardioprotective Drugs”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2023.2514.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Maurizio Giuseppe Guarneri, Laura Nastri, Pasquale Assennato, Angela Li Puma, Arianna Landi, Barbara Bonanno, Giovan Battista Maggì, Giuseppe Annino, Filippa Bono, Daniele La Barbera, Heart ischemia and psychosomatics: the role of stressful events and lifestyles , Monaldi Archives for Chest Disease: Vol. 72 No. 2 (2009): Cardiac series
- B. Chakrabarti, P.D.O. Davies, Pleural tuberculosis , Monaldi Archives for Chest Disease: Vol. 65 No. 1 (2006): Pulmonary series
- Simona Giampaoli, Diego Vanuzzo, Cardiovascular health of the elderly , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
- Laura Miranda, Sarwat Gilani, Liying Han, Oleg Epelbaum, Three's company: A woman with rash, uterine mass and cystic lungs , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Giulia Mattesi, Sara Di Michele, Donato Mele, Ilaria Rigato, Riccardo Bariani, Andrea Fiorencis, Marco Previtero, Abdullah Al Sergani, Loira Leoni, Barbara Bauce, Valeria Pergola, Thyroid dysfunction on the heart: clinical effects, prognostic impact and management strategies , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Fulvio Cacciapuoti, Antonio D’Onofrio, Luca Gaetano Tarquinio, Valentina Capone, Ciro Mauro, Raffaele Marfella, Federico Cacciapuoti, Sleep-disordered breathing and heart failure: a vicious cycle of cardiovascular risk , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- M. Confalonieri, M. Kodric, M. Santagiuliana, C. Longo, M. Biolo, R. Cifaldi, C. Torregiani, M. Jevnikar, To use or not to use corticosteroids for pneumonia? A clinician’s perspective , Monaldi Archives for Chest Disease: Vol. 77 No. 2 (2012): Pulmonary series
- F. Cortopassi, A.A.M. Castro, E.F. Porto, M. Colucci, G. Fonseca, L. Torre-Bouscoulet, V. Iamonti, J.R. Jardim, Comprehensive exercise training improves ventilatory muscle function and reduces dyspnea perception in patients with COPD , Monaldi Archives for Chest Disease: Vol. 71 No. 3 (2009): Pulmonary series
- C. Carbonelli, A. Roggeri, A. Cavazza, M. Zompatori, L. Zucchi, Relapsing bronchiolitis obliterans organising pneumonia and chronic sarcoidosis in an atopic asthmatic patient , Monaldi Archives for Chest Disease: Vol. 69 No. 1 (2008): Pulmonary series
- Franco Tarro Genta, Elena Colajanni, Pierluigi Sbarra, Massimo Tidu, Mauro Rinaldi, Enzo Bosimini, Flow mediated dilation in patient with Berlin Heart Incor left ventricle assist device , Monaldi Archives for Chest Disease: Vol. 70 No. 1 (2008): Cardiac series
<< < 35 36 37 38 39 40 41 42 43 44 > >>
You may also start an advanced similarity search for this article.
