Cardiovascular risk in cancer patients: initial experience from a cardio-oncology clinic in Mexico

Cuitlahuac Arroyo-Rodríguez, Department of Cardiology, Hospital San José, Hermosillo, Son.; Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Son.; Mexico
Arturo E. Espinosa-Picos, Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Son., México
Lorena Ledesma-Lopez, Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Son., México
Marian Rodriguez-Contreras, Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Son., México
Maxwell Avilés-Rodríguez, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Jorge R. Urias-Rocha, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Siria M. Carvajal-Lohr, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Pamela Báez-Islas, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Cynthia Rojas-Camarena, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Hassan Brau-Figueroa, National Network of Cancer Registries, Instituto Nacional de Cancerología, Mexico City, Mexico
Sergio López-Portugal, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Francisco E. Ramirez-Montoya, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
German T. Cabada-Cota, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
Julio C. Abitia-Castro, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México
América Avila-Ariyoshi, Fundación Tres Campanadas, Hospital San José, Hermosillo, Son., Mexico
Enrique Avila-Monteverde, Centro de Alta Especialidad, Oncología San José, Hermosillo, Son., México

Objective: To describe the cardiovascular risk from Mexican patients scheduled to initiate cancer treatment and to compare the risk between oncological and hematological malignancies. Methods: We enrolled patients referred for echocardiography before initiating cancer therapies. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) was evaluated. To estimate the risk for developing cancer therapy-related cardiovascular toxicity (CTR-CVT) we used the Heart Failure Association-International Cardio-Oncology Society risk score (HFA-ICOS). Results: 106 patients were studied, 83% (n = 88) had an oncological, and 17% (n = 18) a hematological malignancy. Breast cancer represented 89.8% (n = 79) of the oncological and lymphoma 61.1% (n = 11) of the hematological malignancies. Patients with oncological malignancies were older (55 ± 11 vs. 46 ± 14 years; p = 0.020) and more frequently female (95.5 vs. 44.4%; p < 0.001). Metastasis was more prevalent in patients with hematological malignancies (38.9 vs. 13.6%; p = 0.011). Mean LVEF was 59.42 ± 6.36 and mean GLS was 20.26 ± 4.89. Prevalence of borderline (50-54%) and reduced LVEF (< 50%) was 4.7 and 3.8%, respectively. Abnormal GLS (< 18%) was identified in 10.4%. HFA-ICOS classified 14.7% of oncological and 10.2% of hematological malignancies in the high and very high-risk categories for developing CTR-CVT (p = 0.68). Conclusions: A high risk for developing CTR-CVT was identified in 14.2% of our population. This risk was comparable among oncological and hematological malignancies.

Keywords: Cardio-oncology. Global longitudinal strain. Echocardiography. Chemotherapy. Cardiotoxicity. Risk prediction.