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Cancer Therapy Suspension due to Cardiovascular Toxicity: Risk Factors and Outcomes
Session:
SESSÃO DE POSTERS 11 - CARDIONCOLOGIA DE PONTA II
Speaker:
Isabel Nóbrega 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:
Isabel Nóbrega Fernandes; Marta Catarina Bernardo; Isabel Martins Moreira; Luís Sousa Azevedo; Alzira Nunes; Ilídio Moreira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">Background: Cancer therapies are under permanent development. However, its potential cardiotoxicity presents a limitation in patients with a substantial cardiovascular (CV) risk, which may require </span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">cancer therapy suspension (CTS).</span></span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">Methods: S</span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">ingle-centre retrospective study of consecutive patients presenting with </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">cancer therapy-related cardiovascular toxicity (CTR-CVT), followed in Cardio-Oncology consultation </span></span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">between May 2021 and July 2024, were analyzed. We aimed to assess characteristics of the population with CTS and its impact on CV events. Major Adverse Cardiovascular Events (MACE) were defined as the composite of all-cause mortality, CV mortality, heart failure, and acute myocardial infarction.</span></span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">Results: In a </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">mean follow-up time of 34 months, a total of </span></span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">43 patients presented </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">CTR-CVT, with 23 patients requiring </span></span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">CTS. Median age (67 versus 64 years) and sex distribution (44% vs 35% males) were similar between patients with and without CTS. There was a higher prevalence of arterial hypertension (91% versus 50%, p=0.003) and diabetes (52% versus 20%, p=0.029) among patients who needed therapy suspension, as well as a tendency towards higher body mass index and higher proportion of preexisting atrial fibrillation (image 1). </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">The most prevalent neoplasm in both groups was breast cancer.</span></span></span></span> <span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">The CV causes for therapy suspension were vascular toxicity (26%), cardiac dysfunction (57%) and arrythmia (17%). </span></span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">Five patients (11%) </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">were able to resume therapy. CTS group had a higher occurrence of MACE (35% </span></span></span></span><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">versus </span></span></span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Calibri Light",sans-serif"><span style="color:#333333">20%, p=0.281), although the Kaplan-Meier curves did not confirm a statistically significant difference. </span></span></span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:10.5pt"><span style="font-family:"Calibri Light",sans-serif"><span style="color:black">Conclusions: Treatment suspension due to CV toxicity occurred in patients with a high burden of comorbidities, yet did not significantly affect clinical outcomes. Preventing CTS through prompt follow-up and a risk-reduction approach can positively impact the morbidity and mortality of these patients.</span></span></span></span></span></span></span></p>
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