Early electrocardiographic changes associated with anticancer chemotherapy in a Sub-Saharan African population: a prospective cohort study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cancer (n=102). Intervention: Anticancer chemotherapy vs. Baseline (pre-chemotherapy). Primary outcome: Any prespecified ECG abnormality (post-cycle 1 vs pre-cycle 1) (p=1.00).

Q: What does this research mean for the field?

Anticancer chemotherapy is associated with post-treatment electrocardiographic abnormalities in over half of patients, most frequently presenting as corrected QT prolongation and repolarisation changes. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Michelle Guimeya; Anastase Dzudie; Eveline Ngouadjeu; Yannick Mboue-Djieka; Sintieh Nchinda Ngek Ekongefeyin; Colette Sih; Peter Vanes Ebasone; Félicité Djuikwo; Albertine Eloundou; Anne Marthe MAISON; Siméon Pierre Choukem

doi:10.1186/s12885-026-16067-2

April 25, 2026BMC CancerOpen Access

Early electrocardiographic changes associated with anticancer chemotherapy in a Sub-Saharan African population: a prospective cohort study

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Key result

Anticancer chemotherapy is linked to ECG abnormalities in ~52% of patients during follow-up.

P=1.00
n=102

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Why the study?

In sub-Saharan Africa, resource limitations restrict advanced cardiac imaging and biomarkers, making 12-lead ECG a pragmatic tool to detect early chemotherapy-associated electrophysiological abnormalities.

Does first-ever anticancer chemotherapy cause early ECG abnormalities in an African adult population?

Key Points

To investigate the frequency, patterns, and predictors of early electrocardiographic (ECG) abnormalities following anticancer chemotherapy in a resource-limited Sub-Saharan African setting.
Conducted a 5-month prospective cohort study at Douala General Hospital, Cameroon, enrolling 102 adults (mean age 48.7 ± 13.5 years; 72.5% women) initiating their first-ever chemotherapy.
Obtained 12-lead ECGs at baseline and 48 hours after each chemotherapy cycle, defining a new abnormality as one present post-cycle that was absent at pre-cycle baseline.
Identified predictors of new ECG abnormalities after cycle 1 using multivariable logistic regression adjusted for age, sex, hypertension, and chemotherapy regimen class.
During follow-up, 53/102 participants (51.9%) had at least one ECG abnormality after chemotherapy, led by prolonged corrected QT interval (19/53, 35.8%), T-wave/repolarisation abnormalities (17/53, 32.0%), sinus rate abnormalities (10/53, 18.8%), and atrial fibrillation (2/53, 3.7%).
In paired cycle 1 analyses (n=102), overall marginal prevalence of prespecified ECG abnormalities was 24.5% pre-cycle versus 24.5% post-cycle (McNemar p=1.00), with 18.6% developing a new abnormality and 18.6% experiencing resolution.
Hypertension was significantly associated with post-chemotherapy ECG abnormalities in univariable analysis (OR 4.03, 95% CI 1.22–13.28), but did not reach statistical significance in the cycle 1 multivariable model (aOR 2.96, 95% CI 0.79–11.03).

Study Design

Type

Cohort (n=102)

Multicenter

No

Structured PICO

Does first-ever anticancer chemotherapy cause early ECG abnormalities in an African adult population?

P

Population

102 adults (≥ 19 years) with cancer initiating first-ever chemotherapy, mean age 48.7, 72.5% female, in Cameroon.

I

Intervention

First-ever anticancer chemotherapy (various regimens including anthracycline, platinum, and taxane-based) with 12-lead ECG surveillance at baseline and 48 hours after each cycle up to 4 cycles.

O

Outcome

New ECG abnormality (defined as an abnormality present post-cycle that was absent at baseline) after the first chemotherapy cycle.safety

Main Result

Absolute Event Rate: 24.5% vs 24.5%

p-value: p=1.00

Limitations

Participant numbers declined substantially after cycle 1, making later-cycle analyses descriptive only
Did not systematically collect treatment modifications or cardiology consultations as outcomes
ECG findings should not be interpreted as synonymous with cardiotoxicity without imaging and biomarkers
ECGs were recorded before treatment and approximately 48 hours after each cycle; transient arrhythmias during infusion and delayed abnormalities later in the cycle may therefore have been missed.
Used resting 12-lead ECGs rather than continuous monitoring and did not measure cardiac biomarkers, electrolytes, or echocardiographic parameters.
Attrition across cycles was substantial, which limits inference beyond cycle 1.

Implication

Early ECG abnormalities, particularly QTc prolongation and repolarization changes, are common following initial chemotherapy in this African cohort, suggesting the utility of routine ECG surveillance in resource-constrained settings.

Discussion

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Cite This Study

Guimeya et al. (2026) conducted a cohort in Cancer (n=102). Anticancer chemotherapy vs. Baseline (pre-chemotherapy) was evaluated on Any prespecified ECG abnormality (post-cycle 1 vs pre-cycle 1) (p=1.00). Anticancer chemotherapy was associated with at least one ECG abnormality in 51.9% of patients during follow-up, though the marginal prevalence of abnormalities before and after cycle 1 was identical at 24.5%.

synapsesocial.com/papers/69eefe1efede9185760d4c4b https://doi.org/10.1186/s12885-026-16067-2

Topics

Cardio-oncology

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Early electrocardiographic changes associated with anticancer chemotherapy in a Sub-Saharan African population: a prospective cohort study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

Topics

Early electrocardiographic changes associated with anticancer chemotherapy in a Sub-Saharan African population: a prospective cohort study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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