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Outcome of anthracycline-related cardiomyopathy – experience of a cardiooncology clinic at a tertiary referral cancer centre

100%

Alahari Dhir A., Daddi A., Sawant S. P.

OncoReview

2017

vol. 7

issue 4

155-161

Introduction: The most common form of cardiotoxicity in cancer treatment is anthracycline-related cardiomyopathy. Objective: To study the factors affecting response to heart failure (HF) therapy in patients with anthracycline- related cardiomyopathy (ARC). Methods: Patients with ARC were included in the study. ARC was defined as left ventricular ejection fraction (LVEF) < 50% in patients who had received anthracycline based chemotherapy. 2Decho was done at baseline and every 3 months after starting anti-heart failure treatment. The primary endpoint of the study was response to anti-heart failure treatment. The patients were considered as responders when LVEF increased at least 10 absolute points. The secondary endpoint was overall survival. Results: 177 patients with ARC were included in the study. The median cumulative dose of doxorubicin was 275 mg/m2. Median clinical follow up duration was 19 months (range 3–73 months). 55% were responders. 25 cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response (p = 0.008), by a factor of 3.07 (95% CI: 1.34–7.05). 25 patients expired. There was a significant difference in overall survival among responders as compared to non-responders (p value: 0.002, log rank test). Conclusions: In patients with ARC cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response to anti-heart failure treatment. Responders have a better overall survival compared to non-responders in patients with ARC.

Cisplatin-induced cardiotoxicity – two case reports

76%

Sawant S. P., Prakruthi J., Daddi A. D., Ghosh J., Joshi A., Alahari Dhir A.

OncoReview

2015

vol. 5

issue 4

A145-150

Cisplatin has been used for over 40 years in various cancer chemotherapies. Toxicity induced by cisplatin-based therapeutic regimens include gastrointestinal toxicity, myelotoxicity, neurotoxicity, ototoxicity and nephrotoxicity. Cisplatin-based regimens have been associated with a wide range of cardiovascular complications. In this paper, we report 2 cases of cisplatin induced cardiotoxicity. We present cases of 2 young patients who developed acute myocardial infarction during combination chemotherapy with bleomycin, etoposide and cisplatin. The first patient had acute anterior wall ST elevation myocardial infarction and the second one had acute myocardial infarction with peripheral arterial thromboembolism. Cisplatin use can result in cardiovascular events. Clinicians should be very cautious while managing patients on cisplatin-based chemotherapy. Early recognition of cardiotoxicity will allow for timely prevention of permanent cardiac damage.

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2 OncoReview

1 2017

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2 Alahari Dhir A.

2 Sawant S. P.

1 Daddi A.

1 Daddi A. D.

1 Ghosh J.

1 Joshi A.

1 Prakruthi J.

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Outcome of anthracycline-related cardiomyopathy – experience of a cardiooncology clinic at a tertiary referral cancer centre

Cisplatin-induced cardiotoxicity – two case reports