Predictive model of early chemotherapy-induced cardiotoxicity in patients with breast cancer

Abstract

Abstract

Introduction: Chemotherapy is a fundamental strategy in the treatment of breast cancer, significantly improving survival. However, it is associated with significant adverse cardiovascular effects, primarily cardiotoxicity, which can manifest early or late. It is one of the leading causes of morbidity and mortality in surviving patients. Identifying early predictive factors of cardiotoxicity is vital to optimize clinical management and prevent serious complications.

Objective: To identify risk factors for early chemotherapy-induced cardiotoxicity in patients with breast cancer.

Method: An analytical cohort study was conducted with 511 patients undergoing oncological treatment, attended in the Cardio-Oncology clinic at Carlos Manuel de Céspedes Hospital between September 2021 and April 2023. Bivariate analyses and logistic regression were applied to identify significant associations with an alpha level of 0.05.

Results: The prevalence of cardiotoxicity was 14.4% (mean age 59.9 ± 12.6 years). Independently associated factors included atrial fibrillation (Exp. β = 22.3; p < 0.001), anemia (Exp. β = 14.9; p < 0.001), dyslipidemia (Exp. β = 5.7; p < 0.001), prolonged QTc interval (Exp. β = 5.5; p < 0.001), smoking (Exp. β = 4.8; p < 0.001), decreased glomerular filtration rate (Exp. β = 4.4; p = 0.002), and hypertensive heart disease (Exp. β = 4.1; p = 0.001).

Conclusions: These factors allow for the development and validation of robust predictive models for early intervention and preventive management of cardiotoxicity in breast cancer patients undergoing chemotherapy.