Risk Factors for Doxorubicin-lnduced Congestive Heart Failure

TLDR

The study retrospectively examined 4,018 patient records to identify risk factors for doxorubicin‑induced congestive heart failure, aiming to help clinicians assess risk/benefit and guide development of less cardiotoxic anthracyclines or preventive strategies. The authors performed a retrospective analysis of 4,018 patient records to assess risk factors for doxorubicin‑induced congestive heart failure. Incidence of doxorubicin‑induced congestive heart failure was 2.2% (88/4,018), with risk rising proportionally to cumulative dose, higher in older patients, lower with weekly dosing, and unrelated to performance status, sex, race, or tumor type.

Abstract

Potential risk factors responsible for development of doxorubicin-induced congestive heart failure were examined through retrospective analysis of 4018 patient records. The overall incidence of drug-induced congestive heart failure was 2.2% (88 cases). The probability of incurring doxorubicin-induced congestive heart failure was related to the total dose of doxorubicin administered. There was a continuum of increasing risk as the cumulative amount of administered drug increased. A weekly dose schedule of doxorubicin was associated with a significantly lower incidence of congestive heart failure than was the usually employed every 3-week schedule. An increase in drug-related congestive heart failure was also seen with advancing patient age. Performance status, sex, race, and tumor type were not risk factors. These data will enable clinicians to better estimate the risk/benefit ratio in individual patients receiving prolonged administration of doxorubicin. They also provide a basis for the investigation of less cardiotoxic anthracycline analogues or for designing measures to prevent doxorubicin-induced cardiomyopathy.