早晨给药蒽环类药物与癌症治疗相关心功能障碍的风险较低相关。

European heart journal open Pub Date : 2025-08-19 eCollection Date: 2025-09-01 DOI:10.1093/ehjopen/oeaf100
Markella I Printezi, Arco J Teske, Nicolaas P A Zuithoff, Kim Urgel, Rhodé M Bijlsma, Anna van Rhenen, Maarten Jan Cramer, Cornelis J A Punt, Anne M May, Linda W van Laake
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引用次数: 0

摘要

目的:临床前研究指出蒽环类药物诱导的癌症治疗相关性心功能障碍(CTRCD)的给药时间依赖性。本回顾性研究旨在探讨一天中服用AC的时间与CTRCD之间的关系。方法和结果:来自两个心脏肿瘤学门诊的患者,接受任何恶性肿瘤的ACs治疗。计算下午给药的百分比:下午(中午12点至晚上11点59分)给药的累积剂量/总累积剂量。分为三组:上午组上午(12 a.m.-11:59 a.m.) ACs≥50%,下午组下午ACs≥50%,中间组上午和下午ACs正好为50%。通过生存分析评估交流时间与CTRCD发生和心力衰竭(HF)之间的关系。在270例纳入的患者中,66例发生CTRCD, 17例发生HF。与早晨组相比,下午组发生CTRCD的风险更高:风险比(HR) 2.88 (95% CI: 1.52 ~ 5.44)。当考虑下午给药的ac百分比作为一个连续变量时,随后每10%的下午给药,发生CTRCD的HR为1.14 (95% CI: 1.04-1.24)。年龄、性别、体重指数、恶性肿瘤类型、累积AC剂量和HFA-ICOS风险评分的敏感性分析结果一致。同样,下午服用AC的连续变量与HF的高风险相关:HR = 1.19 (95% CI: 1.01-1.41)。结论:下午给药与发生CTRCD和HF的风险增加有关,提示上午给药可能更可取。在广泛实施之前,这些发现应在随机对照试验中得到证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Morning administration of anthracyclines is associated with a lower risk of cancer therapy-related cardiac dysfunction.

Morning administration of anthracyclines is associated with a lower risk of cancer therapy-related cardiac dysfunction.

Morning administration of anthracyclines is associated with a lower risk of cancer therapy-related cardiac dysfunction.

Morning administration of anthracyclines is associated with a lower risk of cancer therapy-related cardiac dysfunction.

Aims: Pre-clinical studies point towards an administration time-dependency of anthracycline-induced cancer therapy-related cardiac dysfunction (CTRCD). This retrospective study aimed to investigate the association between time-of-day of AC administration and CTRCD.

Methods and results: Patients from two cardio-oncology outpatient clinics, treated with ACs for any malignancy, were included. Percentage of afternoon AC administration was calculated: cumulative dose administered in the afternoon (12 p.m.-11:59 p.m.)/total cumulative dose. Three groups were defined: morning group ≥ 50% of ACs in the morning (12 a.m.-11:59 a.m.), afternoon group ≥ 50% of ACs in the afternoon, and intermediate group = exactly 50% of ACs in the morning and afternoon. Associations between AC timing and occurrence of CTRCD and heart failure (HF) were assessed using survival analyses. Of 270 included patients, 66 developed CTRCD and 17 developed HF. Compared with the morning group, the afternoon group had a higher risk of developing CTRCD: hazard ratio (HR) 2.88 (95% CI: 1.52-5.44). When considering percentage of ACs administered in the afternoon as a continuous variable, the HR for developing CTRCD was 1.14 (95% CI: 1.04-1.24) for each subsequent 10% of afternoon administration. Results were consistent across sensitivity analyses of age, sex, body mass index, malignancy type, cumulative AC dose, and HFA-ICOS risk score. Congruently, the continuous variable of afternoon AC administration was associated with higher risk of HF: HR = 1.19 (95% CI: 1.01-1.41).

Conclusion: Afternoon administration of ACs is associated with an increased risk of developing CTRCD and HF, suggesting that morning administration may be preferred. Before widespread implementation, these findings should be confirmed in an RCT.

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