Obesity tied to chemotherapy-related cardiotoxicity in patients with breast cancer
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Key takeaways:
- Obesity may be a predictor of chemotherapy-related cardiotoxicity in patients with breast cancer.
- Cardiotoxicity was defined as reduced LVEF or global longitudinal strain.
Overweight/obesity was independently prognostic of chemotherapy-related cardiotoxicity among patients undergoing treatment for breast cancer, according to a small study.
“Cardiotoxicity is a relatively recent concern in cancer care, and its recognition as a significant issue is still evolving. In regions with limited research infrastructure and resources, there may be a lack of specific studies or initiatives addressing cardiotoxicity in the context of breast cancer treatment,” Ivetteh Gaibor Santos, MD, internal medicine specialist at Universidad Autónoma de Bucaramanga/Fundación Oftalmológica de Santander-Foscal in Bucaramanga, Colombia, and cardiology fellow-in-training at Fundación Universitaria de Ciencias de la Salud/Hospital de San José in Bogotá, Colombia, said in a press release.
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To evaluate the impact of obesity on cardiotoxicity among 67 patients undergoing chemotherapy using doxorubicin or trastuzumab (Herceptin, Genentech) for breast cancer, Gaibor Santos and colleagues utilized an anonymized database that consisted of patient data collected in 2021 (mean age, 55 years; mean BMI, 26.18 kg/m2).
The results were presented at the American College of Cardiology Latin America/Asociación Costarricense de Cardiología Congress.
Cardiotoxicity was defined as a decrease in left ventricular ejection fraction of more than 10% and reaching a value below 53% or a reduction of more than 15% in global longitudinal strain in patients with normal LVEF.
At baseline, all participants had normal LVEF prior to chemotherapy and 97% were NYHA class I.
As a side effect of chemotherapy, cardiotoxicity occurred in 11.94% of the overall cohort.
Overall, 20.9% of the cohort had obesity, 14.93% had hypertension and 13.43% had type 2 diabetes.
Gaibor Santos reported that, after multivariable analysis, overweight/obesity was an independent predictor of chemotherapy induced cardiotoxicity (relative potency [RP] = 8.13; 95% CI, 1.06-62.44; P = .04)
“Addressing obesity in cancer patients before starting chemotherapy as well as considering the potential risk for cardiotoxicity requires a comprehensive approach,” Gaibor Santos said in the release. “Some strategies clinicians can consider include pretreatment assessment, lifestyle interventions and cardiovascular risk management. It is important to note that these strategies should be tailored to each patient’s specific needs and in accordance with current evidence-based guidelines.”
Reference:
- Breast cancer patients with higher BMI more likely to experience heart damage during chemotherapy. https://www.eurekalert.org/news-releases/996830. Published Aug. 2, 2023. Accessed Aug. 2, 2023.
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Santos IG. Poster 6: Chemotherapy-induced cardiotoxicity in patients with breast cancer: A single center registry. Presented at: American College of Cardiology Latin America 2023 Together with Asociación Costarricense de Cardiología; Aug. 10-12, 2023; San José, Costa Rica.
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