Badheeb Ahmed M, Ahmed Faisal, Alzahrani Hassan A, Badheeb Mohamed A, Obied Hamoud Y, Seada Islam A
Oncology, Oncology Center, King Khalid Hospital, Najran, SAU.
Urology, Ibb University, Ibb, YEM.
Cureus. 2023 Jul 2;15(7):e41287. doi: 10.7759/cureus.41287. eCollection 2023 Jul.
Background Cardiotoxicity, produced as an adverse effect of anticancer therapy, is a common issue during cancer treatment. Acute coronary syndrome, myocarditis, arrhythmias, or heart failure can all be symptoms of this issue. Little is known about its occurrence among Saudi Arabian cancer patients. This study aims to investigate factors linked to anticancer therapy-related cardiotoxicity. Methods A retrospective study was conducted from April 2020 to May 2022 at the King Khalid Hospital, Najran, Saudi Arabia. The study included adult cancer patients receiving anticancer therapy, regardless of their cardiovascular disease history. Univariate analysis was used to investigate factors associated with the occurrence of cardiotoxicity related to anticancer therapy. Results Of 78 patients receiving anticancer therapy, cardiotoxicity occurred in 12 (15.4%) patients. The mean age was 56.5 ± 13.4 years, with 33.3% aged over 65 years. Comorbidities included hypertension (44; 56.4%), diabetes (41; 52.6%), dyslipidemia (13; 16.7%), smoking (16; 20.5%), heart disease (6; 7.7%), trastuzumab use (9; 11.5%), and chronic kidney disease (2; 2.6%). The most common cancers were breast cancer and gastrointestinal cancer (27.6% each). Monoclonal anticancer agents 35 (46.1%) and alkylating agents 29 (38.2%) were commonly used chemotherapies. Cardiac protective agents were used in 16 (21.1%) of patients, with angiotensin-converting enzyme (ACE) inhibitors 15 (19.7%) and statins (13; 17.1%) being the most prescribed. Baseline ejection fraction (EF) was normal in 69 (90.8%) of cases. The follow-up duration was 1.93 ± 1.90 years. A drop in EF occurred in five (6.6%) of cases. Dyslipidemia (OR: 0.12; 95% CI: 0.03-0.47, p=0.002), previous heart disease (OR: 0.14; 95% CI: 0.02-0.81, p=0.029), and impaired baseline EF (p=0.029) were associated with increased risk of cardiotoxicity. Statin (OR: 0.22; 95% CI: 0.05 to 0.84, p=0.028) and antiplatelet agents (OR: 0.19; 95% CI: 0.03 to 1.01, p=0.051) were protective agents against cardiac toxicity. Conclusion Effective anti-cancer therapy may be accompanied by an increased risk of cardiotoxicity. In this study, a history of prior heart disease, dyslipidemia, low baseline ejection fraction, and the administration of multiple anticancer therapy agents was associated with cardiotoxicity. Proactive management strategies aimed at mitigating the potential cardiotoxic effects of anti-cancer therapies are crucial.
作为抗癌治疗的一种不良反应，心脏毒性是癌症治疗期间的常见问题。急性冠状动脉综合征、心肌炎、心律失常或心力衰竭都可能是该问题的症状。对于沙特阿拉伯癌症患者中其发生率知之甚少。本研究旨在调查与抗癌治疗相关心脏毒性有关的因素。
2020年4月至2022年5月在沙特阿拉伯纳季兰的哈立德国王医院进行了一项回顾性研究。该研究纳入了接受抗癌治疗的成年癌症患者，无论其心血管疾病史如何。采用单因素分析来调查与抗癌治疗相关心脏毒性发生有关的因素。
在78例接受抗癌治疗的患者中，12例（15.4%）发生了心脏毒性。平均年龄为56.5±13.4岁，33.3%的患者年龄超过65岁。合并症包括高血压（44例；56.4%）、糖尿病（41例；52.6%）、血脂异常（13例；16.7%）、吸烟（16例；20.5%）、心脏病（6例；7.7%）、使用曲妥珠单抗（9例；11.5%）和慢性肾病（2例；2.6%）。最常见的癌症是乳腺癌和胃肠道癌（各占27.6%）。常用化疗药物为单克隆抗癌药35例（46.1%）和烷化剂29例（38.2%）。16例（21.1%）患者使用了心脏保护剂，其中血管紧张素转换酶（ACE）抑制剂15例（19.7%）和他汀类药物（13例；17.1%）是最常开具的药物。69例（90.8%）病例的基线射血分数（EF）正常。随访时间为1.93±1.90年。5例（6.6%）病例的EF下降。血脂异常（OR：0.12；95%CI：0.03 - 0.47，p = 0.002）、既往心脏病（OR：0.14；95%CI：0.02 - 0.81，p = 0.029）和基线EF受损（p = 0.029）与心脏毒性风险增加相关。他汀类药物（OR：0.22；95%CI：0.05至0.84，p = 0.028）和抗血小板药物（OR：0.19；95%CI：0.03至1.01，p = 0.051）是预防心脏毒性的保护剂。
有效的抗癌治疗可能伴随着心脏毒性风险增加。在本研究中，既往心脏病史、血脂异常、低基线射血分数以及多种抗癌治疗药物的使用与心脏毒性相关。旨在减轻抗癌治疗潜在心脏毒性作用的积极管理策略至关重要。
