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Chemotherapy-induced cardiovascular risk factors in breast cancer patients: what’s new?
Session:
SESSÃO DE POSTERS 56 - CARDIONCOLOGIA DE PONTA I
Speaker:
Rafaela Fernandes
Congress:
CPC 2025
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Cartazes
FP Number:
---
Authors:
Rafaela Fernandes; Luísa Gomes Rocha; João Borges-Rosa; Rodolfo Silva; Gracinda Costa; Joana Moura Ferreira; Lino Gonçalves; Maria João Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Background</strong>: Breast cancer (BC) is the most common cause of cancer in women. With increasing patient survival rates, it is crucial to understand the long-term effects of BC therapy on survivors’ health. This study aimed to investigate the relationship between different chemotherapy therapies for BC and the development of cardiovascular risk factors (CVRF). </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Methods</strong>: Single-centre retrospective observational study of consecutive women under 55 years with BC, who underwent staging with <sup>18</sup>F-FDG PET/CT prior to treatment between 2018 and 2021. <sup>18</sup>F-FDG vascular uptake was obtained as tissue-to-background ratio (TBR). <sup>18</sup>F-FDG tumour uptake was obtained as metabolic tumour volume (MTV). Total lesion glycolysis (TLG) was the product of MTV and tumour medium SUV. The study endpoints included the new diagnosis of CVRF and the relationship between CVRF, cancer therapy and tumour burden. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Results</strong>: 45 women with BC were included. Mean age was 43.3 (<span style="font-family:Symbol">±</span>7.59) years. 35 (77.8%) had no CVRF, 2 (4.44%) were smokers, 7 (15.6%) had dyslipidaemia, 1 (2.22%) had diabetes <em>mellitus</em>, and 4 (8.89%) had hypertension. Positivity for hormonal receptors was high (oestrogen–30/71.4%; progesterone–24/58.5%), low for human epidermal growth factor-2 receptors (13/31.0%), and 7 (17.1%) were triple negative. Mean follow-up time was 47 (<span style="font-family:Symbol">±</span>14.9) months. All-cause mortality was 22.2% (n=10), with no cardiovascular (CV) mortality or significant CV events. There was only 1 (2.44%) new case of hypertension. A statistically significant increase in dyslipidaemia was observed, with 11 (28.9%) new cases (<em>p-</em>value=0.01). This CVRF was associated with treatment with alkylating agents (<em>p-value</em>=0.031) but not with other chemotherapy agents. No statistically significant relation was observed between new diagnosis of dyslipidaemia and metabolic tumour volume, total lesion glycolysis or aortic TBR at cancer diagnosis. Also, tumour receptor positivity had no statistically significant relation with new diagnosis of dyslipidaemia. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Conclusion</strong>: BC chemotherapy with alkylating agents was associated with new diagnosis of dyslipidaemia. If this increase in lipid levels is sustained in cancer survivor patients is still unknown. However, these findings highlight the risk that this chemotherapy therapy has on CVRF. Larger prospective studies with extended follow-up are needed to determine whether this increase in lipid levels is sustained in cancer survivors and to assess its potential for future cardiovascular events. </span></span></span></p>
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