A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients

Abstract Background Anthracycline usage has been linked to cardiovascular adverse events (CAEs), which is unpredictable. It is critical to identify the characteristics of vulnerable populations and risk factors in order to reduce the occurrence of CAEs. Objectives This meta-analysis aimed to assess...

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Main Authors: Bo Dai, Jingjing Xu, Baiyan Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13305-3
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author Bo Dai
Jingjing Xu
Baiyan Wang
author_facet Bo Dai
Jingjing Xu
Baiyan Wang
author_sort Bo Dai
collection DOAJ
description Abstract Background Anthracycline usage has been linked to cardiovascular adverse events (CAEs), which is unpredictable. It is critical to identify the characteristics of vulnerable populations and risk factors in order to reduce the occurrence of CAEs. Objectives This meta-analysis aimed to assess the correlation between various risk factors and CAEs induced by anthracyclines. Methods We systematically searched for studies from PubMed, Cochrane, Embase, and assessed the publication bias. Anthracyclines, hypertension, radiation therapy, diabetes, smoking, age, gender, hyperlipidemia, and obesity were meta-analyzed using a fixed or random effects model. Result Sixteen studies were included in this meta-analysis. The results showed that pooled relative ratio for CAEs was 1.69 (95% CI: 1.39–2.06, p<0.001) for anthracyclines, and that risk factors for CAEs caused by anthracyclines included hypertension (RR = 2.15, 95% CI: 1.53–3.01, p < 0.001), radiation therapy (RR = 1.71, 95% CI: 1.19–2.47, p < 0.001), diabetes (RR = 1.57, 95% CI: 1.20–2.06, p<0.001), smoking (RR = 1.35, 95% CI: 0.96–1.88, p < 0.05), and age (RR = 1.16, 95% CI: 1.07–1.26, p < 0.001). In addition, BMI > 25 kg/m2 (RR = 1.34, 95% CI: 1.08–1.67, p = 0.470), gender (RR = 1.17, 95% CI: 1.06–1.2, p = 0.350), and hyperlipidemia (RR = 1.10, 95% CI: 0.91–1.34, p = 0.327) was not significantly associated with CAEs caused by anthracyclines. Conclusions Our research findings indicate that patients with a history of hypertension, radiation therapy, diabetes, smoking, and elderly individuals are at an elevated risk of cardiovascular disease in the process of administration of anthracycline drugs. Consequently, careful case selection and condition monitoring are important in the treatment process. Graphical Abstract Patients with comorbidities are more prone to suffering from CAEs with anthracycline based chemotherapy, and the risk factors are arranged clockwise in a descending order: hypertension, radiation therapy, diabetes, smoking, age. BMI>25 kg/m2, gender, and hyperlipidemia are not significant associated with CAEs with anthracycline based chemotherapy.
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spelling doaj-art-80eff8cda8524f9a99d39c87d09c79642025-02-02T12:29:01ZengBMCBMC Cancer1471-24072025-01-0125111210.1186/s12885-024-13305-3A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patientsBo Dai0Jingjing Xu1Baiyan Wang2Xi’an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical UniversityXi’an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical UniversityDepartment of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong UniversityAbstract Background Anthracycline usage has been linked to cardiovascular adverse events (CAEs), which is unpredictable. It is critical to identify the characteristics of vulnerable populations and risk factors in order to reduce the occurrence of CAEs. Objectives This meta-analysis aimed to assess the correlation between various risk factors and CAEs induced by anthracyclines. Methods We systematically searched for studies from PubMed, Cochrane, Embase, and assessed the publication bias. Anthracyclines, hypertension, radiation therapy, diabetes, smoking, age, gender, hyperlipidemia, and obesity were meta-analyzed using a fixed or random effects model. Result Sixteen studies were included in this meta-analysis. The results showed that pooled relative ratio for CAEs was 1.69 (95% CI: 1.39–2.06, p<0.001) for anthracyclines, and that risk factors for CAEs caused by anthracyclines included hypertension (RR = 2.15, 95% CI: 1.53–3.01, p < 0.001), radiation therapy (RR = 1.71, 95% CI: 1.19–2.47, p < 0.001), diabetes (RR = 1.57, 95% CI: 1.20–2.06, p<0.001), smoking (RR = 1.35, 95% CI: 0.96–1.88, p < 0.05), and age (RR = 1.16, 95% CI: 1.07–1.26, p < 0.001). In addition, BMI > 25 kg/m2 (RR = 1.34, 95% CI: 1.08–1.67, p = 0.470), gender (RR = 1.17, 95% CI: 1.06–1.2, p = 0.350), and hyperlipidemia (RR = 1.10, 95% CI: 0.91–1.34, p = 0.327) was not significantly associated with CAEs caused by anthracyclines. Conclusions Our research findings indicate that patients with a history of hypertension, radiation therapy, diabetes, smoking, and elderly individuals are at an elevated risk of cardiovascular disease in the process of administration of anthracycline drugs. Consequently, careful case selection and condition monitoring are important in the treatment process. Graphical Abstract Patients with comorbidities are more prone to suffering from CAEs with anthracycline based chemotherapy, and the risk factors are arranged clockwise in a descending order: hypertension, radiation therapy, diabetes, smoking, age. BMI>25 kg/m2, gender, and hyperlipidemia are not significant associated with CAEs with anthracycline based chemotherapy.https://doi.org/10.1186/s12885-024-13305-3Meta-analysisRisk factorsCardiovascular adverse eventsAnthracycline
spellingShingle Bo Dai
Jingjing Xu
Baiyan Wang
A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
BMC Cancer
Meta-analysis
Risk factors
Cardiovascular adverse events
Anthracycline
title A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
title_full A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
title_fullStr A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
title_full_unstemmed A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
title_short A meta-analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
title_sort meta analysis of risk factors for cardiovascular adverse events with anthracycline based chemotherapy in lymphoma patients
topic Meta-analysis
Risk factors
Cardiovascular adverse events
Anthracycline
url https://doi.org/10.1186/s12885-024-13305-3
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