Key result
Anthracycline chemotherapy is linked to a ~22% incidence of cardiotoxicity in adult cancer patients.
Why the study?
To determine the cumulative incidence, predictors, and associated electrocardiographic and echocardiographic manifestations of anthracycline-induced cardiotoxicity in adult cancer patients at the Uganda Cancer Institute.
Cohort (n=160)
No
Anthracycline-induced cardiotoxicity has a high cumulative incidence (21.9%) in adult cancer patients in Uganda, emphasizing the critical need for routine echocardiographic and electrocardiographic monitoring in this population.
Answers are grounded in this paper and cite their sources.
May support ECG/echo surveillance for AIC in Ugandan adults; leaves open optimal protocols and generalizability to other African settings.
PURPOSE: To determine the cumulative incidence of anthracycline induced cardiotoxicity (AIC), its predictors, and associated electrocardiographic and echocardiographic manifestations in adult cancer patients at Uganda Cancer Institute (UCI). METHODS: We enrolled 160 participants between June 2013 and April 2014 and followed them up for a median of 146 days. Data on clinical, electrocardiographic and echocardiographic findings was obtained at baseline, and at completion of chemotherapy. The Pearson chi square test was used to identify the predictors associated with cardiotoxicity. RESULTS: Of the 64 patients who were accessible for follow-up electrocardiography (ECG) and echocardiography (ECHO), fourteen participants developed cardiotoxicity hence a cumulative incidence rate of 21.9% with 95% CI 13.5%-33.43%. The predictors of AIC were female gender (p=0.025), LVEF (p=0.014) and LVFS (P=0.019). Anthracycline therapy was associated with shortening of the QRS duration (84.3±7.9 Vs 82.1±11.8 ms, p=0.005), prolongation of the QTc interval (411.9±30.7 Vs 447.2±39.4 ms, p=<0.001) and reduction in the LVEF (66.4±7.7 Vs 63.9±8.4%, p=0.026) and LVFS (36.9±6.2 Vs 35.1±6.6%, p=0.03). CONCLUSION: The cumulative incidence of AIC in this study cohort was high. Our findings emphasize the need for early monitoring for AIC.
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Kibudde et al. (2019) conducted a cohort in Cancer (n=160). Anthracycline chemotherapy was evaluated on Reduction in left ventricular ejection fraction (LVEF) of at least 10 percent with or without the presence of symptoms of heart failure (anthracycline induced cardiotoxicity) (95% CI 13.5%-33.43%). Among adult cancer patients receiving anthracycline chemotherapy, the cumulative incidence of cardiotoxicity was 21.9% (95% CI 13.5%-33.43%).
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