Key result
In sarcoma patients receiving doxorubicin-based chemotherapy, cardiotoxicity occurred in 31% of patients, and higher baseline diastolic blood pressure was significantly associated with an increased risk of cardiotoxicity (RR 1.039).
Why the study?
Anthracycline-induced cardiotoxicity is well recognized, but few data exist regarding its real-life incidence and monitoring with sequential CZT-ERNA in sarcoma patients receiving doxorubicin-based chemotherapy.
What is the real-life incidence of cardiotoxicity and associated risk factors in sarcoma patients receiving doxorubicin-based chemotherapy?
Cohort (n=75)
No
What is the real-life incidence of cardiotoxicity and associated risk factors in sarcoma patients receiving doxorubicin-based chemotherapy?
Relative Risk: 1.039 (95% CI 1.001–1.079)
p-value: p=0.042
Cardiotoxicity is a frequent complication (31%) in sarcoma patients treated with doxorubicin, and higher baseline diastolic blood pressure is a significant risk factor for its development.
May support cardiotoxicity vigilance during doxorubicin therapy in sarcoma; hypothesis-generating for baseline diastolic blood pressure as risk factor.
Background Anthracycline induced cardiotoxicity is well recognized but only few data exist in sarcoma patients. This study retrospectively aimed to analyze sequential Cadmium Zinc Telluride (CZT)-multigated equilibrium radionuclide angiography (ERNA) for monitoring left ventricular ejection fraction (LVEF) and to assess the real-life incidence of cardiotoxicity in sarcoma patients receiving doxorubicin based chemotherapy.Materials and methods A retrospective analysis was performed on all sarcoma patients referred to Herlev University Hospital between 2012 and 2015. Cardiotoxicity was defined as a decline in LVEF of > 10% percentage point to a LVEF < 50% as compared to baseline. Early cardiotoxicity was defined as < 1 year and late cardiotoxicity as ≥ 1 year. Recovery of cardiotoxicity was defined as a LVEF ≥ 50%.Results A total of 149 patients were referred, 75 (50%) sarcoma patients were included. The main reason for exclusion was that only one CZT-ERNA had been performed in 50 (68%) of the patients. Twenty-three (31%) of the patients experienced cardiotoxicity, 11 (48%) were female, mean age was 56.9 years. Early cardiotoxicity was observed in 16 (70%) of the patients and 11 (48%) experienced clinical symptoms of cardiotoxicity at diagnosis. Recovery of LVEF was seen in 12 (55%) of the patients and persistent recovery in 10 (45%). The diastolic blood pressure at baseline was positively and significantly associated with a higher risk of developing cardiotoxicity (Relative Risk (RR): 1.039 (95% CI= 1.001 − 1.079; p = 0.042)). The median survival was 1.4 years (range 0.5 − 2.2 years) for patients with metastatic disease versus 3.9 years (range 1.5 − 6.4 years) (p = 0.009) for localized disease at baseline.Conclusion Cardiotoxicity is a relative frequent complication in sarcoma patients treated with doxorubicin based chemotherapy and the diastolic blood pressure at baseline was significantly associated with a higher risk of developing cardiotoxicity.
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Vitfell-Rasmussen et al. (2022) conducted a cohort in Sarcoma (n=75). Baseline diastolic blood pressure was evaluated on Risk of developing cardiotoxicity (LVEF decline >10% to <50%) associated with baseline diastolic blood pressure (RR 1.039, 95% CI 1.001-1.079, p=0.042). In sarcoma patients receiving doxorubicin-based chemotherapy, cardiotoxicity occurred in 31% of patients, and higher baseline diastolic blood pressure was significantly associated with an increased risk of cardiotoxicity (RR 1.039).
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