Dai Bo, Xu Jingjing, Wang Baiyan
Xi'an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi, 710072, China.
Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 West 5th Road, Xi'an, Shaanxi, 710004, China.
BMC Cancer. 2025 Jan 28;25(1):162. doi: 10.1186/s12885-024-13305-3.
Anthracycline usage has been linked to cardiovascular adverse events (CAEs), which is unpredictable. It is critical to identify the characteristics of vulnerable populations and risk factors in order to reduce the occurrence of CAEs.
This meta-analysis aimed to assess the correlation between various risk factors and CAEs induced by anthracyclines.
We systematically searched for studies from PubMed, Cochrane, Embase, and assessed the publication bias. Anthracyclines, hypertension, radiation therapy, diabetes, smoking, age, gender, hyperlipidemia, and obesity were meta-analyzed using a fixed or random effects model.
Sixteen studies were included in this meta-analysis. The results showed that pooled relative ratio for CAEs was 1.69 (95% CI: 1.39-2.06, p<0.001) for anthracyclines, and that risk factors for CAEs caused by anthracyclines included hypertension (RR = 2.15, 95% CI: 1.53-3.01, p < 0.001), radiation therapy (RR = 1.71, 95% CI: 1.19-2.47, p < 0.001), diabetes (RR = 1.57, 95% CI: 1.20-2.06, p<0.001), smoking (RR = 1.35, 95% CI: 0.96-1.88, p < 0.05), and age (RR = 1.16, 95% CI: 1.07-1.26, p < 0.001). In addition, BMI > 25 kg/m (RR = 1.34, 95% CI: 1.08-1.67, p = 0.470), gender (RR = 1.17, 95% CI: 1.06-1.2, p = 0.350), and hyperlipidemia (RR = 1.10, 95% CI: 0.91-1.34, p = 0.327) was not significantly associated with CAEs caused by anthracyclines.
Our research findings indicate that patients with a history of hypertension, radiation therapy, diabetes, smoking, and elderly individuals are at an elevated risk of cardiovascular disease in the process of administration of anthracycline drugs. Consequently, careful case selection and condition monitoring are important in the treatment process.
蒽环类药物的使用与心血管不良事件（CAEs）相关，且这种关联不可预测。识别脆弱人群的特征和风险因素对于减少CAEs的发生至关重要。
本荟萃分析旨在评估各种风险因素与蒽环类药物所致CAEs之间的相关性。
我们系统检索了PubMed、Cochrane、Embase中的研究，并评估了发表偏倚。使用固定效应或随机效应模型对蒽环类药物、高血压、放射治疗、糖尿病、吸烟、年龄、性别、高脂血症和肥胖进行荟萃分析。
本荟萃分析纳入了16项研究。结果显示，蒽环类药物所致CAEs的合并相对比值为1.69（95%CI：1.39 - 2.06，p<0.001），蒽环类药物所致CAEs的风险因素包括高血压（RR = 2.15，95%CI：1.53 - 3.01，p < 0.001）、放射治疗（RR = 1.71，95%CI：1.19 - 2.47，p < 0.001）、糖尿病（RR = 1.57，95%CI：1.20 - 2.06，p<0.001）、吸烟（RR = 1.35，95%CI：0.96 - 1.88，p < 0.05）和年龄（RR = 1.16，95%CI：1.07 - 1.26，p < 0.001）。此外，体重指数>25 kg/m（RR = 1.34，95%CI：1.08 - 1.67，p = 0.470）、性别（RR = 1.17，95%CI：1.06 - 1.2，p = 0.350）和高脂血症（RR = 1.10，95%CI：0.91 - 1.34，p = 0.327）与蒽环类药物所致CAEs无显著相关性。
我们的研究结果表明，有高血压、放射治疗、糖尿病、吸烟史的患者以及老年人在接受蒽环类药物治疗过程中发生心血管疾病的风险升高。因此，在治疗过程中仔细进行病例选择和病情监测很重要。
