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.

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

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2025年1月28日

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Bo Dai,
Jingjing Xu,
Baiyan Wang

摘要

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.