Cristina Crisan1, Calin Cainap1,3*, Anca Farcas3,4, Tiberiu Moldovan1, Eduard Radu1, Ovidiu Bochis1, Gabriela Morar-Bolba1, Adina Stan5*, Alina Bereanu6*, Catalin Vlad1,2, Patriciu Achimas1,2*, Simona Cainap2,3
1“Prof. Dr. Ion Chiricuta” Oncology Institute of Cluj-Napoca, Romania.
2Emergency County Hospital for Children, Pediatric Clinic no 2, Cluj-Napoca, Romania.
3“Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
4Emergency County Hospital, Internal Medicine no 1, Cluj-Napoca, Romania.
5Department of Neuroscience, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
6Faculty of Medicine, “Lucian Blaga”University of Sibiu, Sibiu, Romania.
*These authors contributed equally to this article.
Summary
Purpose: Chemotherapy cardiotoxicity sometimes occurs as QTc prolongation, which may lead to ventricular arrhythmia. We assessed incidence of QTc prolongation among chemotherapy-treated patients.
Methods: We enrolled 396 consecutive patients receiving chemotherapy in the Oncology Institute of Cluj-Napoca, Romania. 870 ECGs were performed at baseline and every 2 months, for 5 assessments, during 2016.
Results: Most patients were diagnosed with gastro-intestinal tumors and received regimens containing more than one drug. No particular chemotherapy regimen was proved to significantly increase QTc. Maximum QTc was recorded after 4 months, when we also found the maximum incidence of increased QTc (>470ms), of 3.73% and of increased ΔQTc (>60ms), of 4%. Female gender was associated with a higher baseline QTc=421 ms, ± 26.9 (p=0.02). Age was linked to higher QTc and is also an independent variable predicting QTc prolongation (for QTc>480ms, p=0.02), as well as increase of ΔQTc (p<0.001). The number of prior chemotherapy lines correlates with baseline QTc (p<0.0001), with QTc prolongation after 2 months (p=0.01) and predicts higher ΔQTc after 2 months (p=0.01), although within normal range. There was no additive effect during all the 5 assessments.
Conclusion: Our results confirm QTc prolongation with chemotherapy and a special attention should be paid to previously treated patients and to elderly patients.
Key words: chemotherapy, cardiotoxicity, QTc prolongation.
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