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Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: the CARDIOTOX registry
- Source :
- European Heart Journal. 41:1720-1729
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- Aim Cardiotoxicity (CTox) is a major side effect of cancer therapies, but uniform diagnostic criteria to guide clinical and research practices are lacking. Methods and results We prospectively studied 865 patients, aged 54.7 ± 13.9; 16.3% men, scheduled for anticancer therapy related with moderate/high CTox risk. Four groups of progressive myocardial damage/dysfunction were considered according to current guidelines: normal, normal biomarkers (high-sensitivity troponin T and N-terminal natriuretic pro-peptide), and left ventricular (LV) function; mild, abnormal biomarkers, and/or LV dysfunction (LVD) maintaining an LV ejection fraction (LVEF) ≥50%; moderate, LVD with LVEF 40–49%; and severe, LVD with LVEF ≤40% or symptomatic heart failure. Cardiotoxicity was defined as new or worsening of myocardial damage/ventricular function from baseline during follow-up. Patients were followed for a median of 24 months. Cardiotoxicity was identified in 37.5% patients during follow-up [95% confidence interval (CI) 34.22–40.8%], 31.6% with mild, 2.8% moderate, and 3.1% with severe myocardial damage/dysfunction. The mortality rate in the severe CTox group was 22.9 deaths per 100 patients-year vs. 2.3 deaths per 100 patients-year in the rest of groups, hazard ratio of 10.2 (95% CI 5.5–19.2) (P Conclusions The majority of patients present objective data of myocardial injury/dysfunction during or after cancer therapy. Nevertheless, severe CTox, with a strong prognostic relationship, was comparatively rare. This should be reflected in protocols for clinical and research practices.
- Subjects :
- Adult
Male
medicine.medical_specialty
Side effect
Heart failure
030204 cardiovascular system & hematology
Ventricular Function, Left
Ventricular Dysfunction, Left
03 medical and health sciences
0302 clinical medicine
Internal medicine
Prevalence
medicine
Chemotherapy
Humans
Registries
030212 general & internal medicine
1102 Cardiorespiratory Medicine and Haematology
Aged
Left ventricular dysfunction
Cardiotoxicity
Ejection fraction
Radiotherapy
Troponin T
business.industry
Mortality rate
Hazard ratio
1103 Clinical Sciences
Stroke Volume
Middle Aged
medicine.disease
Confidence interval
Cardio-oncology
Cardiovascular System & Hematology
Myocardial injury
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15229645 and 0195668X
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- European Heart Journal
- Accession number :
- edsair.doi.dedup.....e6d86b7ca77834e48a81e473ff21c513