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Open Access 01-12-2023 | Breast Cancer | Research

Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka

Authors: Jayasinghe Arachchige Nirosha Sandamali, Ruwani Punyakanthi Hewawasam, Madappuli Arachchige Chaminda Sri Sampath Fernando, Kamani Ayoma Perera Wijewardana Jayatilaka

Published in: BMC Cancer | Issue 1/2023

Abstract

Background

The clinical application of anthracycline chemotherapy is hindered due to the cumulative dose-dependent cardiotoxicity followed by the oxidative stress initiated during the mechanism of action of anthracyclines. Due to a lack of prevalence data regarding anthracycline-induced cardiotoxicity in Sri Lanka, this study was conducted to determine the prevalence of cardiotoxicity among breast cancer patients in Southern Sri Lanka in terms of electrocardiographic and cardiac biomarker investigations.

Methods

A cross-sectional study with longitudinal follow-up was conducted among 196 cancer patients at the Teaching Hospital, Karapitiya, Sri Lanka to determine the incidence of acute and early-onset chronic cardiotoxicity. Data on electrocardiography and cardiac biomarkers were collected from each patient, one day before anthracycline (doxorubicin and epirubicin) chemotherapy, one day after the first dose, one day and six months after the last dose of anthracycline chemotherapy.

Results

Prevalence of sub-clinical anthracycline-induced cardiotoxicity six months after the completion of anthracycline chemotherapy was significantly higher (p < 0.05) and there were strong, significant (p < 0.05) associations among echocardiography, electrocardiography measurements and cardiac biomarkers including troponin I and N-terminal pro-brain natriuretic peptides. The cumulative anthracycline dose, > 350 mg/m² was the most significant risk factor associated with the sub-clinical cardiotoxicity in breast cancer patients under study.

Conclusion

Since these results confirmed the unavoidable cardiotoxic changes following anthracycline chemotherapy, it is recommended to carry out long-term follow-ups in all patients who were treated with anthracycline therapy to increase their quality of life as cancer survivors.

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Title: Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka
Authors: Jayasinghe Arachchige Nirosha Sandamali
Ruwani Punyakanthi Hewawasam
Madappuli Arachchige Chaminda Sri Sampath Fernando
Kamani Ayoma Perera Wijewardana Jayatilaka
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Breast Cancer
Electrocardiography
Breast Cancer
Anthracycline
Electrocardiography
Cytostatic Therapy
Published in: BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-023-10673-0

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