A Cross-sectional Study On Cardiotoxicity And Intervention Of Anthracycline Anticancer Drugs

Objective:To study the cardiotoxicity of tumor drugs in anthracycline,to explore the high risk factors of cardiotoxicity,and to develop better intervention measures.Methods: Collected 120 patients hospitalized in the Oncology Department of Sichuan Provincial People’s Hospital from October 2018 to October2020,were devided into protective group(dexorazosin plus doxorubicin)and non-protective group(doxorubicin)according to treatment regimens.Laboratory indicators and cardiac ultrasound data before and after chemotherapy were compared between the two groups to judge and compare the cardiotoxicity of the two groups.The risk factors were screened out by univariate analysis,and multivariate regression analysis was conducted based on the high risk,medium risk and low risk calculated by SCORE model.Finally,the risk factors and protective factors of cardiotoxicity caused by anthracycline antitumor drugs were screened out.Results:(1)In the laboratory test,there were significant differences in BNP and cTnI before and after chemotherapy in the unprotected group(P < 0.05).After chemotherapy,there were significant differences in BNP and cTnI expression between the protected group and the unprotected group(P < 0.001).(2)The expression level of LVEF before and after chemotherapy in the non-protective group was statistically different(P < 0.05).(3)There was no direct correlation between BNP level and LVEF and LVFS in the two groups before and after chemotherapy(P > 0.05).(4)There were 11 cases of cardiotoxicity in the non-protective group,and the incidence of cardiotoxicity was 20%(11/55),which was much higher than that of the protective group(4.62%,3/65).The incidence of cardiotoxicity was significantly different between the two groups(P<0.05).(5)There were statistically significant differences in the rates of arrhythmia and heart failure between the two groups after one course of treatment(P < 0.05),and there were also statistically significant differences in the mortality rates within one year after four courses of treatment between the two groups(P < 0.05).Compared with the protection group and the non-protection group,there were significant differences in the mortality rates due to cardiovascular causes between the two groups(P < 0.05).There was also significant difference in the median time of death(P < 0.05).(6)In this study,32 patients with high risk,34 patients with medium risk,and 54 patients with low risk were taken risk value as the dependent variable.Logistic regression step-by-step method was used to screen the risk factors,and the occurrence and protection of cardiovascular risk of anthracycline anti-tumor drugs,myotoxic reactions,BNP,There was a significant correlation between age and LVEF(sig.P<0.05 and 95%C was not equal to 1).Conclusion:BNP and cTnI were significantly increased before and after chemotherapy,which could be used as an indicator of cardiac toxicity during ANT chemotherapy.EF may be used as one of the early warning monitoring indicators for some patients at high risk of cardiotoxicity.However,high expression of myotoxic reaction,increased BNP expression,age 55-65 years old,and decreased LVEF are high risk factors for cardiovascular risk of anthracyclines,and the use of protective drugs is a protective factor for cardiovascular risk of anthracyclines.