Chemotherapy-induced cardiotoxicity in cancer patients

Keywords

Neoplasms - antineoplastic agents - heart disease risk factors - cardiotoxicity - cardio-oncology

Introduction: In recent years, there have been significant advances in cancer treatment with the discovery of new drugs and therapies that improve the prognosis of cancer patients. However, despite the benefits, cardiovascular diseases have emerged as one of the main adverse effects of antineoplastic therapy, contributing to patient morbidity and mortality. Although chemotherapy plays an important role in the outcomes of cancer patients, the use of some classes of chemotherapy has resulted in increasing cases of side effects and cardiovascular complications, the most common occurrence being the development of chemotherapy-induced cardiotoxicity, which extends after treatment.

Objective: To identify and describe the factors that characterize cardiovascular toxicity in a sample of cancer patients undergoing outpatient chemotherapy.

Methods: Descriptive observational study conducted with adult patients with stage I, II or III cancer, with indication for outpatient chemotherapy in a hospital in southeastern Brazil. Sociodemographic data and tumor characterization were obtained through medical records and a semi-structured questionnaire. Electrocardiogram assessment and blood collection for biomarker analysis were collected before the infusion of the first chemotherapy in the patient. Descriptive analyses were conducted in the R software.

Results: The most prevalent chemotherapy protocols in the study were Docetaxel® associated with cyclophosphamide® (22.62%) followed by Adriamycin® associated with Cyclophosphamide® (17.85%). The mean C-reactive protein was 6.83 mg/l with 30 participants presenting high cardiovascular risk. In contrast, only 1 participant had elevated troponin 1. Prolongation of the QT interval was identified in 11.90% of the sample.

Conclusion: Cancer patients undergoing chemotherapy protocols, mainly anthracyclines® and taxanes®, associated with some previous risk factor, have an increased risk of chemotherapy-induced cardiotoxicity. In addition, C-reactive protein levels were increased in a large part of the sample. The findings draw attention to the cardiovascular risk of these patients.

Corresponding author: Luís Carlos Lopes-Júnior (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025