Chemotherapy-induced cardiotoxicity in cancer patients: an observational study at an Oncology reference hospital from southeastern Brazil

Abstract

Objective: to assess the clinical, inflammatory and electrocardiographic profile of cancer patients undergoing the Pre-chemotherapy phase, with the purpose of early identifying cardiovascular toxicity indicative signs. Method: an observational and cross-sectional study, conducted between November2022 and December2023 with adult cancer patients in stagesI toIII treated at a hospital from southern Brazil. Sociodemographic, clinical and tumor-related data were collected, in addition to laboratory and electrocardiographic tests performed before the first chemotherapy infusion. Descriptive analyses were carried out in the Rsoftware. Results: the participants were 84 patients, mostly women (72.6%) with breast cancer diagnoses(57.1%). Prevalence of systemic inflammation was verified, with high C-reactive protein in 35.7% and increased neutrophil-lymphocyte and platelet-lymphocyte ratios in 23.5% and 27.2%, respectively. A significant association was observed between high Body Mass Index and T-wave alterations (p=0.005). Although 10 patients presented prolonged corrected QT intervals, no other statistically significant associations were identified. Conclusion: the pre-chemotherapy phase revealed relevant inflammatory and electrocardiographic alterations, even in the absence of installed cardiotoxicity. The findings reinforce the importance of baseline cardiovascular evaluations and of multi-professional follow-up in Cardio-Oncology, especially for patients with modifiable risk factors. Longitudinal studies are recommended to elucidate the clinical and prognostic evolution of these alterations.