Prevalence and Risk Factors of Cardiotoxicity in Elderly Cancer Patients

Document Type : Original Article

Authors

1 Dar El-Salam Oncology Center, Cairo, Egypt

2 Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

3 Department of Cardiology, National Heart Institute, Ministry of Health, Giza, Egypt

4 Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University. Geriatric Palliative Care Unit, Ain Shams University Hospitals, Cairo, Egypt.

Abstract

Background: Cancer and heart disease are the leading causes of death in older adults. Cardiotoxicity of anticancer agents may lead to under-treatment of elderly patients, resulting in suboptimal outcomes.
Aim: To determine the prevalence and risk factors of cardiotoxicity in elderly patients with cancer.
Patients and Methods: The study sample included one hundred (100) elderly subjects, both males and females, aged sixty years and above. The study participants were subjected to the following: comprehensive geriatric assessment (CGA), laboratory work-up (fasting blood glucose, lipid profile, and C-reactive protein), electrocardiography (ECG), and echocardiography (ECHO).
Results: The prevalence of cardiotoxicity (any pattern) was 57%. Patients who experienced cardiotoxicity were older, and had higher smoking index, lower body mass index, and longer cancer duration. They had a higher prevalence of hypertension, diabetes, and dyslipidemia and had higher mean levels of C-reactive protein. Participants who had received certain chemotherapeutic agents (e.g., Anthracycline), certain targeted therapy agents (e.g., Pertuzumab); and those who received radiotherapy (delivered to the chest) were more liable for cardiotoxicity. Cardiotoxicity was associated with malnutrition, depression and functional decline in the affected patients.
Conclusion: Cardiotoxicity is common in elderly patients with cancer. It is associated with certain risk factors; such as smoking, dyslipidemia, hyperglycemia, malnutrition and certain anticancer treatments. Comprehensive geriatric assessment is essential in the management of elderly cancer patients.
 

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