Intima-media thickness, myocardial perfusion and laboratory risk factors of atherosclerosis in patients with breast cancer treated with anthracycline-based chemotherapy

Abstract

An increased incidence of complications of atherosclerosis has been noted in cancer survivors. The aim of the present study was to evaluate, in patients with breast carcinoma, the effect of antracycline-based chemotherapy on carotid intima-media thickness (IMT), myocardial perfusion, assessed by single-photon emission tomography (SPECT) and laboratory parameters associated with the risk of atherosclerosis. Thirty-six patients with breast cancer were evaluated before and after anthracycline-based chemotherapy. Retinol, alpha-tocopherol, glycosylated hemoglobin and urinary neopterin were measured by high-performance liquid chromatography. Peripheral blood cell count, D-dimers, fibrinogen, antithrombin, glucose, magnesium, creatinine, uric acid, albumin, C-reactive protein, lipoprotein (a), cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, homocysteine, urinary albumin and N-acetyl-beta-D-glucosaminidase (NAG) were determined with routine methods. No significant differences were observed between patients and 16 controls. Compared to the measurement before the start of therapy, peripheral blood leukocyte and platelet count, hemoglobin, creatinine, HDL cholesterol, retinol, albumin, urinary albumin and NAG decreased, and total cholesterol, LDL cholesterol, triglycerides, neopterin and mean IMT increased significantly after the treatment. Of the 36 patients who had SPECT after treatment, perfusion defects were noted only in two cases, including the patient who had perfusion defects at baseline examination and a patient who did not have a baseline SPECT. In conclusion, a significant increase in carotid IMT, total cholesterol, LDL cholesterol, triglycerides and urinary neopterin and a decrease of peripheral blood leukocyte and platelet counts, hemoglobin, creatinine, HDL cholesterol, retinol, albumin and NAG were observed after the treatment.

Is carotid stiffness a possible surrogate for stroke in long-term survivors of childhood cancer after neck radiotherapy?

“…They proposed that antracyclines induces oxidative stress that can lead to higher incidence of cardiovascular events. 27 Inside the group of survivors we studied the association between traditional cerebrovascular risk factors and PWV. In a multivariate analysis, we found a significant association between smoking and PWV; it was pointed out that smoking habit might have an additional negative influence on vascular aging in the group of patients after neck RT.…”

Comparison of performance of composite biomarkers of inflammatory response in determining the prognosis of breast cancer patients

“…At the same time, accumulating evidence indicates that the administration of systemic therapy could cause the acceleration of atherosclerosis [43]. Inflammatory response induced by tumor growth or systemic therapy may accelerate the progression of atherosclerosis in patients with breast cancer [44].…”

Laboratory medicine and medical oncology: the tale of two Cinderellas

“…Laboratory risk factors of atherosclerosis in patients with cancer are, similar to the general population, associated with alterations of parameters of immune and inflammatory response [110] . A negative impact of chemotherapy on the risk factors of atherosclerosis has also been described in patients with breast cancer [111] . Another example of late toxicity with devastating consequences is represented by second primary tumors, including myeloid neoplasms, that may be associated with genetic predisposition [112] , e.g., BRCA-1 mutations, that are being increasingly used in testing persons at risk [33,113] .…”