Real-world Study of Cardiotoxicity in Patients with Advanced Colorectal Cancer due to Bevacizumab-combination Chemotherapy
Objective To investigate the effect of bevacizumab(BVZ)in combination with chemotherapy on cardiac indexes of patients with advanced colorectal cancer.Methods A total of 215 patients with advanced colorectal cancer who were hospitalised at The First Affiliated Hospital of Nanchang University between 1 January 2020 and 31 December 2022 were selected.Patients were divided into two groups according to whether or not BVZ was used:the group with combined BVZ chemotherapy(group A,n=138)and the group with chemotherapy alone(group B,n=77).Within group A,a subgroup analysis was performed based on the number of chemotherapy cycles.In addition,patients with pre-existing cardiovascular risk factors were excluded from groups A and B and further subdivided into subgroups C and D for the analysis.Patient characteristics,changes in cardiac enzyme profiles,blood pressure measurements and electrocardiograms before and after drug administration were compared.Results 1.There was no significant difference in the clinical characteristics of patients in groups A and B(P>0.05).2.Comparison of electrocardiogram abnormality rate:group A was significantly higher than group B(P<0.05);subgroup analysis showed a significant increase in group C compared with group D(P<0.05).3.Changes in cardiac enzyme profiles showed increased levels of CK-MB,CK and LDH in group A,while there was no significant change in group B.In addition,there were significant differences in CK-MB and LDH between the two groups(P<0.05).Subgroup analysis showed that:the blood pressure of patients in the second stage of treatment was significantly higher than that in the first stage(P<0.05);the differences in CK,CK-MB,and LDH in group C compared with that in group D were not significant(P>0.05).Conclusion The use of BVZ is associated with cardiac injury,which depends on the frequency of administration.The measurement parameters including CK-MB,LDH and electrocardiogram may serve as important tests for the early detection of cardiac injury.
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