Fluoropyrimidine-induced cardiotoxicity as a complication of multiagent chemotherapy for colorectal cancer: data from the Moscow registry

Aim. To evaluate the prognostic value of the SCORE2/SCORE2-OP scales and the level of cardiac biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI)) for fluoropyrimidine-induced cardiotoxicity (FIC) in the short term. Material and methods. This prospective, single-center cohort study included 133 patients with colorectal cancer (stages II-IV) receiving fluoropyrimidine therapy. Before treatment, the risk of cardiovascular events (CVEs) was stratified using the SCORE2/SCORE2-OP scales and NT-proBNP and hs-TnI levels were determined. CVEs were assessed during a 6-month follow-up. Results. One hundred and three (77,4%) patients were classified as having high/very high cardiovascular risk. CVEs developed in thirty-nine patients (29,3%), the most common of which were thromboembolic events (9,8%) and blood pressure destabilization (9,8%). No significant associations were found between SCORE2/SCORE2-OP risk stratification, NT-proBNP, or hs-TnI levels, and FIC. Conclusion. Traditional cardiovascular risk factors and cardiac biomarkers do not demonstrate prognostic value for FIC in the short term. This supports the hypothesis of fundamentally different mechanisms for FIC compared to atherosclerotic events.