Cardiovascular risk assessment and modifying cardiotoxicity in breast cancer patients receiving Anthracyclines and Anti-HER2 Therapy

Abstract Background Cardiovascular diseases (CVDs) are a significant concern in cancer treatment, with increasing evidence suggesting that cancer therapies, particularly anthracyclines and anti-human epidermal growth factor receptor-2 (HER2) monoclonal antibodies, can contribute to premature cardiovascular morbidity and mortality. Cardiotoxicity, resulting from these treatments, poses a challenge for the continued administration of cancer therapies. Early identification of cardiotoxicity risk factors and the implementation of timely therapeutic interventions are critical to optimizing patient outcomes and maintaining cancer treatment continuity. Objectives This study aims to: Review and modify the current cardiotoxicity risk score for breast cancer patients. Identify protective cardiovascular factors and confirm the importance of cardiovascular risk assessment in this cohort. Optimize heart health and ensure safe continuation of cancer treatments. Gather preliminary data on the prevalence of cardiotoxicity, focusing on modifiable and non-modifiable cardiovascular risk factors in breast cancer patients undergoing anthracycline and anti-HER2 therapy. Methods This prospective study involves 212 breast cancer patients receiving anthracyclines and anti-HER2 therapy at our hospital. The sample size was calculated using STATA17 software, based on a population of 514 patients who received anthracyclines and anti-HER2 treatment in the previous year, with a prevalence rate of 34% for cardiotoxicity. A 95% confidence interval and 5% relative precision were used, resulting in a sample size of 212 patients. Results A total of 119 patients were recruited for the study, all diagnosed with early-stage breast cancer and treated at region. Of these, 30 patients were identified as high-risk for severe cardiotoxicity. Conclusion This study identifies nationality and heart rate as significant predictors of cardiotoxicity in breast cancer patients undergoing anthracycline and anti-HER2 therapy. These findings underscore the importance of considering these factors in the development of risk models and personalized treatment strategies. Although age and triglycerides were associated with cardiotoxicity risk, further investigation with larger sample sizes is needed to clarify their roles. These insights are essential for improving cardiovascular risk assessments and optimizing heart health management in breast cancer patients.