Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka
Abstract Background The clinical application of anthracycline chemotherapy is hindered due to the cumulative dose-dependent cardiotoxicity followed by the oxidative stress initiated during the mechanism of action of anthracyclines. Due to a lack of prevalence data regarding anthracycline-induced car...
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BMC
2023-03-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-10673-0 |
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| author | Jayasinghe Arachchige Nirosha Sandamali Ruwani Punyakanthi Hewawasam Madappuli Arachchige Chaminda Sri Sampath Fernando Kamani Ayoma Perera Wijewardana Jayatilaka |
| author_facet | Jayasinghe Arachchige Nirosha Sandamali Ruwani Punyakanthi Hewawasam Madappuli Arachchige Chaminda Sri Sampath Fernando Kamani Ayoma Perera Wijewardana Jayatilaka |
| author_sort | Jayasinghe Arachchige Nirosha Sandamali |
| collection | DOAJ |
| description | Abstract Background The clinical application of anthracycline chemotherapy is hindered due to the cumulative dose-dependent cardiotoxicity followed by the oxidative stress initiated during the mechanism of action of anthracyclines. Due to a lack of prevalence data regarding anthracycline-induced cardiotoxicity in Sri Lanka, this study was conducted to determine the prevalence of cardiotoxicity among breast cancer patients in Southern Sri Lanka in terms of electrocardiographic and cardiac biomarker investigations. Methods A cross-sectional study with longitudinal follow-up was conducted among 196 cancer patients at the Teaching Hospital, Karapitiya, Sri Lanka to determine the incidence of acute and early-onset chronic cardiotoxicity. Data on electrocardiography and cardiac biomarkers were collected from each patient, one day before anthracycline (doxorubicin and epirubicin) chemotherapy, one day after the first dose, one day and six months after the last dose of anthracycline chemotherapy. Results Prevalence of sub-clinical anthracycline-induced cardiotoxicity six months after the completion of anthracycline chemotherapy was significantly higher (p < 0.05) and there were strong, significant (p < 0.05) associations among echocardiography, electrocardiography measurements and cardiac biomarkers including troponin I and N-terminal pro-brain natriuretic peptides. The cumulative anthracycline dose, > 350 mg/m2 was the most significant risk factor associated with the sub-clinical cardiotoxicity in breast cancer patients under study. Conclusion Since these results confirmed the unavoidable cardiotoxic changes following anthracycline chemotherapy, it is recommended to carry out long-term follow-ups in all patients who were treated with anthracycline therapy to increase their quality of life as cancer survivors. |
| first_indexed | 2024-04-09T22:51:35Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-09T22:51:35Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-6cbe2ecb4af04a22ad18a19f473f726c2023-03-22T11:35:35ZengBMCBMC Cancer1471-24072023-03-0123111710.1186/s12885-023-10673-0Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri LankaJayasinghe Arachchige Nirosha Sandamali0Ruwani Punyakanthi Hewawasam1Madappuli Arachchige Chaminda Sri Sampath Fernando2Kamani Ayoma Perera Wijewardana Jayatilaka3Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of RuhunaDepartment of Biochemistry, Faculty of Medicine, University of RuhunaDepartment of Economics & Statistics, Faculty of Social Sciences & Languages, Sabaragamuwa University of Sri LankaDepartment of Biochemistry, Faculty of Medicine, University of RuhunaAbstract Background The clinical application of anthracycline chemotherapy is hindered due to the cumulative dose-dependent cardiotoxicity followed by the oxidative stress initiated during the mechanism of action of anthracyclines. Due to a lack of prevalence data regarding anthracycline-induced cardiotoxicity in Sri Lanka, this study was conducted to determine the prevalence of cardiotoxicity among breast cancer patients in Southern Sri Lanka in terms of electrocardiographic and cardiac biomarker investigations. Methods A cross-sectional study with longitudinal follow-up was conducted among 196 cancer patients at the Teaching Hospital, Karapitiya, Sri Lanka to determine the incidence of acute and early-onset chronic cardiotoxicity. Data on electrocardiography and cardiac biomarkers were collected from each patient, one day before anthracycline (doxorubicin and epirubicin) chemotherapy, one day after the first dose, one day and six months after the last dose of anthracycline chemotherapy. Results Prevalence of sub-clinical anthracycline-induced cardiotoxicity six months after the completion of anthracycline chemotherapy was significantly higher (p < 0.05) and there were strong, significant (p < 0.05) associations among echocardiography, electrocardiography measurements and cardiac biomarkers including troponin I and N-terminal pro-brain natriuretic peptides. The cumulative anthracycline dose, > 350 mg/m2 was the most significant risk factor associated with the sub-clinical cardiotoxicity in breast cancer patients under study. Conclusion Since these results confirmed the unavoidable cardiotoxic changes following anthracycline chemotherapy, it is recommended to carry out long-term follow-ups in all patients who were treated with anthracycline therapy to increase their quality of life as cancer survivors.https://doi.org/10.1186/s12885-023-10673-0AnthracyclineBreast cancer patientsCardiotoxicityElectrocardiographyNT-proBNPTroponin I |
| spellingShingle | Jayasinghe Arachchige Nirosha Sandamali Ruwani Punyakanthi Hewawasam Madappuli Arachchige Chaminda Sri Sampath Fernando Kamani Ayoma Perera Wijewardana Jayatilaka Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka BMC Cancer Anthracycline Breast cancer patients Cardiotoxicity Electrocardiography NT-proBNP Troponin I |
| title | Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka |
| title_full | Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka |
| title_fullStr | Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka |
| title_full_unstemmed | Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka |
| title_short | Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka |
| title_sort | electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from southern sri lanka |
| topic | Anthracycline Breast cancer patients Cardiotoxicity Electrocardiography NT-proBNP Troponin I |
| url | https://doi.org/10.1186/s12885-023-10673-0 |
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