Major Cardiac Events and the Value of Echocardiographic Evaluation in Patients Receiving Anthracycline-Based Chemotherapy
| Autor: | Marielle Scherrer-Crosbie, Elkan F. Halpern, Hong-wen Fei M.D., Irene Kuter, Timothy C. Tan, Arthur E. Weyman, Tomas G. Neilan, Lin Wang, Michael H. Picard, Ephraim P. Hochberg, Jeremy S. Abramson, Sanjeev A. Francis |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Anthracycline Heart Ventricles medicine.medical_treatment Population Ventricular Function Left Risk Factors Neoplasms Internal medicine medicine Humans Anthracyclines cardiovascular diseases education Retrospective Studies Cardiotoxicity Chemotherapy education.field_of_study Ejection fraction business.industry Incidence Stroke Volume Middle Aged Prognosis medicine.disease Massachusetts Cardiovascular Diseases Echocardiography Heart failure Cohort Cardiology Female Cardiology and Cardiovascular Medicine business Mace Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 116:442-446 |
| ISSN: | 0002-9149 |
| Popis: | Anthracyclines are an important component of cancer treatments; however, their use is limited by the occurrence of cardiotoxicity. There are limited data on the occurrence of heart failure and the value of baseline and follow-up measurements of left ventricular (LV) ejection fraction (EF) in the current era. Therefore, the objectives of the present study were twofold: (1) to characterize the occurrence of and risk factors for major adverse cardiac events (MACEs: symptomatic heart failure and cardiac death) in a large contemporaneous population of adult patients treated with anthracyclines and (2) to test the value of LVEF and LV dimensions obtained using echocardiography in the prediction of MACE. Five thousand fifty-seven patients were studied, of whom 124 (2.4%) developed MACE. Of the total cohort, 2,285 patients had an available echocardiogram pre-chemotherapy. Patients with MACE were older (p0.0001), predominantly men (p = 0.03), and with a higher incidence of cardiovascular risk factors and cardiac treatments. Patients with hematologic cancers had a higher incidence of cardiac events than patients with breast cancer (4.2% vs 0.7%, p0.0001). Baseline LVEF, LVEF ≤5 points above the lower limits of normal, and LV internal diameter were predictive of the rate of occurrence of MACE. In conclusion, older patients with hematologic cancers and patients with a baseline LVEF ≤5 points above the lower limit of normal have higher incidence of MACE and should be closely monitored. |
| Databáze: | OpenAIRE |
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