Outcome of anthracycline-related cardiomyopathy – experience of a cardiooncology clinic at a tertiary referral cancer centre Original article
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Abstract
Introduction: The most common form of cardiotoxicity in cancer treatment is anthracycline-related cardiomyopathy.
Objective: To study the factors affecting response to heart failure (HF) therapy in patients with anthracycline- related cardiomyopathy (ARC).
Methods: Patients with ARC were included in the study. ARC was defined as left ventricular ejection fraction (LVEF) < 50% in patients who had received anthracycline based chemotherapy. 2Decho was done at baseline and every 3 months after starting anti-heart failure treatment. The primary endpoint of the study was response to anti-heart failure treatment. The patients were considered as responders when LVEF increased at least 10 absolute points. The secondary endpoint was overall survival.
Results: 177 patients with ARC were included in the study. The median cumulative dose of doxorubicin was 275 mg/m2. Median clinical follow up duration was 19 months (range 3–73 months). 55% were responders. 25 cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response (p = 0.008), by a factor of 3.07 (95% CI: 1.34–7.05). 25 patients expired. There was a significant difference in overall survival among responders as compared to non-responders (p value: 0.002, log rank test).
Conclusions: In patients with ARC cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response to anti-heart failure treatment. Responders have a better overall survival compared to non-responders in patients with ARC.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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