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ECG scoring for the evaluation of therapy-naïve cancer patients to predict cardiotoxicity

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Item Type:Article
Title:ECG scoring for the evaluation of therapy-naïve cancer patients to predict cardiotoxicity
Creators Name:Pohl, J. and Mincu, R.I. and Mrotzek, S.M. and Wakili, R. and Mahabadi, A.A. and Potthoff, S.K. and Siveke, J.T. and Keller, U. and Landmesser, U. and Rassaf, T. and Anker, M.S. and Totzeck, M.
Abstract:OBJECTIVE: To evaluate a new electrocardiographic (ECG) score reflecting domains of electrical and structural alterations in therapy-naïve cancer patients to assess their risk of cardiotoxicity. METHODS: We performed a retrospective analysis of 134 therapy-naïve consecutive cancer patients in our two university hospitals concerning four ECG score parameters: Contiguous Q-waves, markers of left ventricular (LV) hypertrophy, QRS duration and JTc prolongation. Cardiotoxicity was assessed after a short-term follow-up (up to 12 months). RESULTS: Of all the patients (n = 25), 19% reached 0 points, 50% (n = 67) reached 1 point, 25% (n = 33) reached 2 points, 5% (n = 7) reached 3 points and 0.7% reached 4 or 5 points (n = 1 respectively). The incidence of cardiotoxicity (n = 28 [21%]) increased with the ECG score, with 0 points at 0%, 1 point 7.5%, 2 points 55%, 3 points 71% and ≥3 points 50%. In the ROC (Receiver operating curves) analysis, the best cut-off for predicting cardiotoxicity was an ECG score of ≥2 points (sensitivity 82%, specificity 82%, AUC 0.84, 95% CI 0.77-0.92, p < 0.0001) which was then defined as a high-risk score. High-risk patients did not differ concerning their age, LV ejection fraction, classical cardiovascular risk factors or cardiac biomarkers compared to those with a low-risk ECG score. CONCLUSION: ECG scoring prior to the start of anti-cancer therapies may help to identify therapy-naïve cancer patients at a higher risk for the development of cardiotoxicity. SIMPLE SUMMARY: Due to improved survival upon effective anti-cancer therapies, the management of treatment-related side-effects is of increasing interest and importance. Cardiovascular side-effects of chemo-, targeted- and/or immunotherapies are common and can be harmful. To date, the identification of patients who could experience those cardiovascular side-effects prior to the anti-cancer therapy start is difficult. We show that the use of a simple electrocardiographic (ECG) score can help to predict the occurrence of cardiovascular toxicity of anti-cancer therapies.
Keywords:ECG, Cardio-Oncology, Cancer, Score, Cardiotoxicity
Source:Cancers
ISSN:2072-6694
Publisher:MDPI
Volume:13
Number:6
Page Range:1197
Date:10 March 2021
Official Publication:https://doi.org/10.3390/cancers13061197
PubMed:View item in PubMed

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