Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center
Background. Anthracycline chemotherapy is a cornerstone of cancer treatment but poses a risk of cardiotoxicity, often presenting as cancer therapy–related cardiac dysfunction (CTRCD). Monitoring left ventricular ejection fraction (LVEF) is essential to detect early cardiac impairment and support saf...
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Professional Edition Eastern Europe
2025-06-01
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| Series: | Український журнал серцево-судинної хірургії |
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| Online Access: | https://cvs.org.ua/index.php/ujcvs/article/view/734 |
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| author | Rizkyastari Onny Tutik Harjianti Pendrik Tandean Syakib Bakri Himawan Sanusi Andi Alfian Zainuddin |
| author_facet | Rizkyastari Onny Tutik Harjianti Pendrik Tandean Syakib Bakri Himawan Sanusi Andi Alfian Zainuddin |
| author_sort | Rizkyastari Onny |
| collection | DOAJ |
| description | Background. Anthracycline chemotherapy is a cornerstone of cancer treatment but poses a risk of cardiotoxicity, often presenting as cancer therapy–related cardiac dysfunction (CTRCD). Monitoring left ventricular ejection fraction (LVEF) is essential to detect early cardiac impairment and support safer treatment strategies.
Aim. To assess LVEF changes after six cycles of anthracycline therapy and identify predictive factors associated with CTRCD.
Materials and methods. This observational pre–post study included 74 patients treated with anthracyclines at Dr. Wahidin Sudirohusodo Hospital, Makassar, from 2024 to 2025. LVEF was measured via echocardiographic surveillance before and after treatment. Cardiotoxicity was defined as a ≥10 % decrease in LVEF to ≤50 %. Statistical tools included Wilcoxon signed-rank test, Chi-square, ROC curve analysis, and logistic regression.
Results. The mean LVEF significantly declined from 63.08 % to 56.76 % (p = 0.001). CTRCD occurred in 20.3 % of patients. Risk factors independently associated with cardiotoxicity included age ≥51 years (OR 2.80; p = 0.016) and cumulative anthracycline dose ≥457.5 mg/m² (OR 3.25; p = 0.004). When both factors were present, the risk increased nearly sixfold (OR 5.75; p = 0.001).
Conclusions. CTRCD was observed in one-fifth of patients following anthracycline therapy, with age and dose being significant contributors. These findings support the integration of risk-based echocardiographic surveillance into oncology care to ensure early detection and mitigate long-term cardiac complications. |
| format | Article |
| id | doaj-art-e44234ed4aaa408f87d40d7810fe04ae |
| institution | Kabale University |
| issn | 2664-5963 2664-5971 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Professional Edition Eastern Europe |
| record_format | Article |
| series | Український журнал серцево-судинної хірургії |
| spelling | doaj-art-e44234ed4aaa408f87d40d7810fe04ae2025-08-20T03:26:57ZengProfessional Edition Eastern EuropeУкраїнський журнал серцево-судинної хірургії2664-59632664-59712025-06-01332758010.63181/ujcvs.2025.33(2).75-80734Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care CenterRizkyastari Onny0https://orcid.org/0009-0006-9762-4726Tutik Harjianti1https://orcid.org/0000-0002-9731-5193Pendrik Tandean2https://orcid.org/0000-0002-6600-4763Syakib Bakri3https://orcid.org/0000-0002-6615-5166Himawan Sanusi4https://orcid.org/0000-0003-3828-2958Andi Alfian Zainuddin5https://orcid.org/0000-0003-4590-6407Hasanuddin University, Makassar, IndonesiaHasanuddin University, Makassar, IndonesiaHasanuddin University, Makassar, IndonesiaHasanuddin University, Makassar, IndonesiaHasanuddin University, Makassar, IndonesiaHasanuddin University, Makassar, IndonesiaBackground. Anthracycline chemotherapy is a cornerstone of cancer treatment but poses a risk of cardiotoxicity, often presenting as cancer therapy–related cardiac dysfunction (CTRCD). Monitoring left ventricular ejection fraction (LVEF) is essential to detect early cardiac impairment and support safer treatment strategies. Aim. To assess LVEF changes after six cycles of anthracycline therapy and identify predictive factors associated with CTRCD. Materials and methods. This observational pre–post study included 74 patients treated with anthracyclines at Dr. Wahidin Sudirohusodo Hospital, Makassar, from 2024 to 2025. LVEF was measured via echocardiographic surveillance before and after treatment. Cardiotoxicity was defined as a ≥10 % decrease in LVEF to ≤50 %. Statistical tools included Wilcoxon signed-rank test, Chi-square, ROC curve analysis, and logistic regression. Results. The mean LVEF significantly declined from 63.08 % to 56.76 % (p = 0.001). CTRCD occurred in 20.3 % of patients. Risk factors independently associated with cardiotoxicity included age ≥51 years (OR 2.80; p = 0.016) and cumulative anthracycline dose ≥457.5 mg/m² (OR 3.25; p = 0.004). When both factors were present, the risk increased nearly sixfold (OR 5.75; p = 0.001). Conclusions. CTRCD was observed in one-fifth of patients following anthracycline therapy, with age and dose being significant contributors. These findings support the integration of risk-based echocardiographic surveillance into oncology care to ensure early detection and mitigate long-term cardiac complications.https://cvs.org.ua/index.php/ujcvs/article/view/734anthracyclinecardiotoxicitycancer therapy–related cardiac dysfunctionechocardiographic surveillancecumulative doseejection fraction |
| spellingShingle | Rizkyastari Onny Tutik Harjianti Pendrik Tandean Syakib Bakri Himawan Sanusi Andi Alfian Zainuddin Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center Український журнал серцево-судинної хірургії anthracycline cardiotoxicity cancer therapy–related cardiac dysfunction echocardiographic surveillance cumulative dose ejection fraction |
| title | Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center |
| title_full | Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center |
| title_fullStr | Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center |
| title_full_unstemmed | Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center |
| title_short | Ejection Fraction Decline and Cardiotoxicity Following Anthracycline Chemotherapy: A Risk-Focused Study from an Indonesian Tertiary Care Center |
| title_sort | ejection fraction decline and cardiotoxicity following anthracycline chemotherapy a risk focused study from an indonesian tertiary care center |
| topic | anthracycline cardiotoxicity cancer therapy–related cardiac dysfunction echocardiographic surveillance cumulative dose ejection fraction |
| url | https://cvs.org.ua/index.php/ujcvs/article/view/734 |
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