Cardiovascular risk in cancer patients: initial experience from a cardio-oncology clinic in Mexico.

Cuitlahuac Arroyo-Rodríguez, Arturo E Espinosa-Picos, Lorena Ledesma-Lopez, Marian Rodriguez-Contreras, Maxwell Avilés-Rodríguez, Jorge R Urias-Rocha, Siria M Carvajal-Lohr, Pamela Báez-Islas, Cynthia Rojas-Camarena, Hassan Brau-Figueroa, Sergio López-Portugal, Francisco E Ramirez-Montoya, German T Cabada-Cota, Julio C Abitia-Castro, América Avila-Ariyoshi, Enrique Avila-Monteverde
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Abstract

Objective: To describe the cardiovascular risk from Mexican patients scheduled to initiate cancer treatment and to compare the risk between oncological and hematological malignancies.

Methods: We enrolled patients referred for echocardiography before initiating cancer therapies. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) was evaluated. To estimate the risk for developing cancer therapy-related cardiovascular toxicity (CTR-CVT) we used the Heart Failure Association-International Cardio-Oncology Society risk score (HFA-ICOS).

Results: 106 patients were studied, 83% (n = 88) had an oncological, and 17% (n = 18) a hematological malignancy. Breast cancer represented 89.8% (n = 79) of the oncological and lymphoma 61.1% (n = 11) of the hematological malignancies. Patients with oncological malignancies were older (55 ± 11 vs. 46 ± 14 years; p = 0.020) and more frequently female (95.5 vs. 44.4%; p < 0.001). Metastasis was more prevalent in patients with hematological malignancies (38.9 vs. 13.6%; p = 0.011). Mean LVEF was 59.42 ± 6.36 and mean GLS was 20.26 ± 4.89. Prevalence of borderline (50-54%) and reduced LVEF (< 50%) was 4.7 and 3.8%, respectively. Abnormal GLS (< 18%) was identified in 10.4%. HFA-ICOS classified 14.7% of oncological and 10.2% of hematological malignancies in the high and very high-risk categories for developing CTR-CVT (p = 0.68).

Conclusions: A high risk for developing CTR-CVT was identified in 14.2% of our population. This risk was comparable among oncological and hematological malignancies.

癌症患者的心血管风险:来自墨西哥心脏肿瘤诊所的初步经验。
目的:描述计划开始癌症治疗的墨西哥患者的心血管风险,并比较肿瘤和血液系统恶性肿瘤的风险。方法:我们招募了在开始癌症治疗前进行超声心动图检查的患者。评估左室射血分数(LVEF)和整体纵向应变(GLS)。为了评估发生癌症治疗相关心血管毒性(cvt)的风险,我们使用心力衰竭协会-国际心脏肿瘤学会风险评分(HFA-ICOS)。结果:106例患者中,83% (n = 88)为肿瘤,17% (n = 18)为血液恶性肿瘤。乳腺癌占肿瘤恶性肿瘤的89.8% (n = 79),淋巴瘤占血液恶性肿瘤的61.1% (n = 11)。恶性肿瘤患者年龄较大(55±11岁∶46±14岁);P = 0.020),女性更常见(95.5% vs. 44.4%;P < 0.001)。转移在血液系统恶性肿瘤患者中更为普遍(38.9%比13.6%;P = 0.011)。平均LVEF为59.42±6.36,平均GLS为20.26±4.89。边缘(50-54%)和LVEF降低(< 50%)的患病率分别为4.7%和3.8%。10.4%的人发现GLS异常(< 18%)。HFA-ICOS将14.7%的肿瘤和10.2%的血液系统恶性肿瘤归为发展为cvt的高风险和非常高风险类别(p = 0.68)。结论:14.2%的人群存在发生cvt的高风险。这种风险在肿瘤和血液恶性肿瘤中是相当的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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