Key result
Cardiologic monitoring in doxorubicin-treated cancer patients with risk factors was associated with a CHF incidence of 6% vs 17% without monitoring (P=0.107), and reduced CHF mortality.
Why the study?
Does cardiologic monitoring reduce the incidence, mortality, and severity of heart failure in cancer patients treated with doxorubicin?
Cohort
Does cardiologic monitoring reduce the incidence, mortality, and severity of heart failure in cancer patients treated with doxorubicin?
Cardiologic monitoring in high-risk cancer patients receiving doxorubicin may reduce heart failure severity and mortality, allowing for higher cumulative doxorubicin doses.
Answers are grounded in this paper and cite their sources.
Monitoring may lower CHF mortality in high-risk doxorubicin patients; hypothesis-generating and requires RCTs before practice change.
We compared the incidence of heart failure (CHF), CHF mortality and CHF severity in cancer patients (pts) treated with doxorubicin (DXR) in the presence and absence of cardiologic monitoring (CM). CM consisted of endomyocardial biopsy and right heart catheterization as definitive tests with and without echocardiograms and phonocardiographically derived systolic time intervals as screening tests. CHF incidence was very low (0.03) in non-CM pts without risk factors (RF). RF pts had a CHF incidence of 0.17 without and 0.06 with CM (P = 0.107). Five of 58 RF pts in the non-CM group and 0 of 49 RF pts in the CM group died of problems related to CHF. CHF symptomatology by NYHA criteria was less in CM RF pts than non-CM RF pts (P = 0.034). The prevention of CHF mortality and morbidity in CM pts was not due to administering less DXR, as CM pts actually received an average of 43 mg/m2 more DXR than non-CM pts. We conclude that pts without RF need no CM during treatment with DXR, and that CM can reduce CHF severity and CHF mortality in RF pts.
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Bristow et al. (1982) conducted a cohort in Cancer. Cardiologic monitoring vs. No cardiologic monitoring was evaluated on Incidence of heart failure (CHF) in patients with risk factors (p=0.107). Cardiologic monitoring in doxorubicin-treated cancer patients with risk factors was associated with a CHF incidence of 6% vs 17% without monitoring (P=0.107), and reduced CHF mortality.
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