Abstract 16133: Body Mass Index Predicts Cardiac Toxicity Following Anthracycline-Based Chemotherapy
Background: Anthracycline Cardiotoxicity (AC) represents a major limitation for its use in cancer patients (pts). Within a study aimed to assess AC and to identify risk factors, we evaluate the influence of Body Mass Index (BMI) in the development of AC.
Methods: 105 consecutive pts receiving Anthracycline (A)-based chemotherapy (CHT) (96% for breast cancer) were included in this prospective study. All Pts underwent clinical evaluation, an echocardiogram, and blood test at baseline, at the end of A CHT, and 3 and 9 months after the end of A CHT, for a total follow-up of one year. AC was diagnosed when heart failure, sudden cardiac death, left ventricular systolic dysfunction (LVSD) or diastolic dysfunction (DD) appeared during follow-up. Variables assessed were age, hypertension, hypercholesterolemia, diabetes, smoking status, BMI, radiotherapy on left hemithorax, dose of A and CHT scheme. 16 patients with baseline DD were excluded from this analysis.
Results: One year cumulative incidence of AC was 57.3% (95%CI= 46.5-68.1) (51 out of 89 patients: 1 pt with sudden cardiac death, 3 pts with LVSD and the remaining with DD). Despite that doses were calculated according to body surface, in the univariate analysis BMI and age were associated with AC (table). Compared with normal weight pts, OR for overweight and obese pts were respectively 2.6 (95%CI 0.92-7.30, p=0.08) and 7.6 (95% CI 2.1-26.9, p=0.0017). In the logistic regression model, BMI and age were independently related with the development of AC, with the following odds ratio values: BMI 1.21 (95% CI 1.05-1.39), age 1.15(95%CI 1.05-1.25). Inclusion or not of vascular risk factors does not substantially modify these estimates.
Conclusions: Development of cardiac damage after Anthracycline chemotherapy is common, mainly expressed as diastolic dysfunction. BMI and age are independently associated with cardiac toxicity following Anthracycline chemotherapy. Every unit of increase in BMI increases the risk of AC by 21%.
- © 2013 by American Heart Association, Inc.