Chemotherapy-induced cardiotoxicity in cancer patients: an observational study at an Oncology reference hospital from southeastern Brazil.
Karoline Neumann, Karolini Zuqui Nunes, Wesley Rocha Grippa and 3 others
PMID 41563305WHAT IT FOUND
Before first chemotherapy, 84 cancer patients had baseline risk signs: high C-reactive protein in 30, abnormal ECG tracing in 10, and high troponin in 1.
Links between drug combinations, inflammation, and tracing changes were mostly absent.
Key findings
01Before first chemotherapy, 30 patients had high C-reactive protein risk, 1 had high troponin, and 10 had prolonged QTc.
02Chemotherapy drug combinations and C-reactive protein risk were not significantly associated with prolonged QTc.
03BMI above 20.5 was associated with inverted T-wave, and waist circumference was associated with tachycardia.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a single-center study with a small, mixed cancer population, so the findings may not apply to other hospitals or patient groups. It was cross-sectional and had no control group, so it cannot show whether chemotherapy caused cardiac changes or predict who would develop cardiotoxicity. Some analyses used fewer patients, such as 78, because of missing laboratory or ECG data, which may reduce statistical power. All measurements were taken before the first chemotherapy infusion, so true chemotherapy-induced cardiotoxic effects had not yet had time to appear. TroponinI was high in only 1 patient, and C-reactive protein can be raised by diabetes, infection, obesity, or tumor burden, so these markers are not specific for chemotherapy-related heart injury. No echocardiogram or NT-proBNP testing was performed, so cardiac structure and function were not directly assessed.
Declared interests
The work was supported by Fundação de Amparo à Pesquisa e Inovação do Espírito Santo (FAPES), grant 2021-5BDLS. No company funding or other conflict of interest is stated.
The easy way to misread this
Do not read this as evidence that chemotherapy caused cardiac changes. All measurements were taken before the first chemotherapy infusion, and the study did not follow patients over time.