Risk factors of acute cardiotoxicity induced by anthracyclines in patients with breast cancer
Objective To investigate the risk factors of acute cardiotoxicity induced by anthracyclines in patients with breast cancer.Methods The clinical data of 280 female patients with breast cancer who received anthracycline chemotherapy in Anyang Tumor Hospital from June 2021 to June 2023 were retrospectively analyzed.They were 38 to 67(52.13±8.43)years old.Their body mass index(BMI)was 19 to 25(22.49±2.12)kg/m2.The general data of all the patients were collected.They were divided into an occurrence group(125 cases)and a non-occurrence group(155 cases)according to the criteria of acute cardiotoxicity.The baseline data of the two groups were compared;the factors with statistical significance in the baseline data were included into the multivariate logistic regression analysis model to screen the risk factors for acute cardiotoxicity in the patients.The statistical analysis was performed by t and x2 tests.Results The incidence of acute cardiotoxicity was 44.64％(125/280);among them,5 cases(4.00％,5/125)had two or more electrocardiograph abnormalities.Acute cardiotoxicity occurred in all the patients within six months after the completion of chemotherapy,and the clinical manifestations of all the patients were abnormal electrocardiogram;the more common ones were sinus tachycardia[26.40％(33/125)],QTC interval change[22.40％(28/125)],T wave change[16.80％(21/125)],etc.The results of univariate analysis showed that the proportions of the patients ≥ 55 years old,with menopause,with history of diabetes,with history of hypertension,with history of hyperlipidemia,and who took the combination of trastuzumab and the combination of dextrazone in the occurrence group was higher than those in the non-occurrence group[32.00％(40/125)vs.21.29％(33/155),60.00％(75/125)vs.18.71％(29/155),31.20％(39/125)vs.6.45％(10/155),29.60％(37/125)vs.12.90％(20/155),16.00％(20/125)vs.7.74％(12/155),28.00％(35/125)vs.12.90％(20/155),and 72.80％(91/125)vs.41.94％(65/155)];the levels of creatine kinase isoenzyme and α-hydroxybutyrate dehydrogenase in the occurrence group were higher than those in the non-occurrence group[(16.02±6.00)U/L vs.(12.54±5.01)U/L and(139.78±31.75)U/L vs.(132.78±20.45)U/L];there were statistical differences(x2=4.12,50.53,29.36,11.90,4.66,9.99,and 26.72;t=5.29 and 2.23;all P＜0.05).The results of multivariate logistic regression analysis showed that age,menopause,diabetes history,combined trastuzumab,creatine kinase isoenzyme,and α-hydroxybutyrate dehydrogenase were the risk factors for acute cardiotoxicity in the patients(OR=1.015,17.133,1.744,4.096,4.175,and 2.085;all P＜0.05);combined dexrazoxane was a protective factor against acute cardiotoxicity in the patients(OR=0.613,P＜0.05).Conclusions Age,menopause,diabetes history,combined trastuzumab,creatine kinase isoenzyme,and α-hydroxybutyrate dehydrogenase are risk factors for acute cardiotoxicity induced by anthracycline chemotherapy in patients with breast cancer,while combined dexrazoxane is a protective factor.Therefore,relevant clinical measures should be taken accordingly to reduce the incidence of acute cardiotoxicity.
Breast cancerAnthracyclinesChemotherapy drugsAcute cardiotoxicityRisk factors
万方数据
维普
