A recent study in North-East Colombia found that 11.94% of high BMI breast cancer patients receiving chemotherapy at a local facility experienced cardiotoxicity. In collaboration with the Costa Rican Association of Cardiologists, the study will be presented at ACC Latin America 2023 in San Jose.

the study’s lead author Ivetteh Gaibor Santos, MD, an internal medicine specialist at Universidad Autónoma de Bucaramanga/Fundación Oftalmológica de Santander-Foscal in Bucaramanga, Colombia, and cardiology fellow-in-training at Fundación Universitaria de Ciencias de la Salud/Hospital de San José in Bogotá, Colombia said -

“Cardiotoxicity is a relatively recent concern in cancer care, and its recognition as a significant issue is still evolving. In regions with limited research infrastructure and resources, there may be a lack of specific studies or initiatives addressing cardiotoxicity in the context of breast cancer treatment.”

Cardiovascular Risks in Breast Cancer

Breast cancer patients who received doxorubicin or trastuzumab chemotherapy from January to December 2021 were the subject of a study using an anonymous database. In addition to sociodemographic, oncological, cardiovascular, and echocardiographic information, only patients with initial and follow-up echocardiograms were examined.

The study encompassed 67 patients, averaging 55 years with a BMI of 26.18 kg/m². Initial traits included obesity (20.9%), hypertension (14.93%), and Type 2 diabetes (13.43%).

All had normal left ventricular ejection fraction before chemo. Cardiotoxicity rate was 11.94%, attributed solely to elevated BMI (25 and above). Presented at ACC Latin America 2023, San Jose, Costa Rica.

Gaibor Santos, who added that all patients in this study were taking antihypertensive drugs said -

“Obesity is itself a risk factor for the development of breast cancer and cardiovascular disease like heart failure but it isn’t often properly managed, unlike other prevalent risk factors like high blood pressure.”

Chemotherapeutic agents, which are formulated according to body surface area instead of body composition, may lead to further risk of cardiotoxicity in patients with obesity due to over- or under-dosing, she said.

Role of BMI During Chemotherapy

Early identification of cardiotoxicity and its factors is crucial for managing adverse effects, assert the researchers. To enhance awareness among healthcare professionals and the public about cancer treatment-associated cardiotoxicity risks, they propose actions such as:

1. Improved medical education on cardiotoxicity in medical schools and continuing medical education.

2. Multidisciplinary cooperation between specialties to foster clinician and patient comprehension, facilitating early detection and intervention.

3. Backing research efforts centered on cardiotoxicity in cancer treatment.

4. Utilization of digital resources for convenient clinician access to current cardiotoxicity information.

Gaibor Santos further added -

“Addressing obesity in cancer patients before starting chemotherapy as well as considering the potential risk for cardiotoxicity requires a comprehensive approach.

Some strategies clinicians can consider include pre-treatment assessment, lifestyle interventions, and cardiovascular risk management. It is important to note that these strategies should be tailored to each patient’s specific needs and in accordance with current evidence-based guidelines.

I am convinced that this is the first of many investigations that will come in the future regarding cardio-oncology in Colombia, and I am thrilled to continue working in this field because I know there are so many patients that could be benefited from the results of our upcoming studies.”