Document Detail


Age and left ventricular ejection fraction identify patients with advanced breast cancer at high risk for development of epirubicin-induced heart failure.
MedLine Citation:
PMID:  9456189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To evaluate the possibility of predicting development of heart failure, we monitored left ventricular ejection fraction (LVEF) in addition to demographic data in patients with advanced breast cancer treated with epirubicin. METHODS AND RESULTS: LVEF determination by radionuclide angiocardiography was performed serially before, during, and after treatment with 130 mg epirubicin/m2 every 3 weeks until disease progression or a cumulative dose of 1000 mg/m2 was reached (or heart failure occurred). Among 67 patients, heart failure developed in eight (12%). Age was 5 to 8 years greater and baseline LVEF was 7% less (95% confidence interval 3% to 13%) in patients who had heart failure than in the remaining patients. LVEF was slightly reduced in all patients during treatment. Three combined criteria, age > or =50 years, baseline LVEF < or =0.60, and decrease in LVEF to 0.50, had a positive predictive value of 70% (95% confidence interval 35% to 93%) and a negative predictive value of 98% (95% confidence interval 90% to 100%) with respect to development of heart failure. Conventional LVEF criteria were of less diagnostic value. CONCLUSIONS: Our results indicate that age and baseline LVEF determination mark a group of patients at high risk for development of epirubicin-induced heart failure. Monitoring of serial LVEF is indicated during treatment of these patients.
Authors:
B Schaadt; H Kelbaek
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  4     ISSN:  1071-3581     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-03-05     Completed Date:  1998-03-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  494-501     Citation Subset:  IM    
Affiliation:
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Antibiotics, Antineoplastic / adverse effects*
Breast Neoplasms / drug therapy*
Epirubicin / adverse effects*
Female
Heart / radionuclide imaging*
Heart Failure / chemically induced*
Humans
Male
Middle Aged
Risk
Stroke Volume / drug effects*
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 56420-45-2/Epirubicin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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