Drug-induced cardiotoxicity associated with the use of antitumor antibiotics

• Dariya D. Perepechko
• Galina S. Mal’

Abstract

The risk of developing cardiotoxicity against the background of the antibiotic use with antitumor activity is one of the most pressing problems in modern oncology and cardiology. Cardiotoxic complications significantly impair the life quality of patients and shorten lifespan, and mortality from cardiovascular diseases still ranks first worldwide. There are several hypotheses for this pathology occurrence, but the theory with the participation of the topoisomerase enzyme isconsidered as the main one.

Currently, there are many risk factors for the cardiotoxicity development. These include age, female sex, negroid race, history of radiation exposure to the mediastinum, and some others. The main cardiotoxic effects are cardiomyopathies, arrhythmias, pain in the heart region, electrocardiogram changes. Most often, patients are diagnosed with myocarditis, pericarditis, acute myocardial infarction, chronic heart failure.

In 2012 a cardiotoxicity classification of the anthracycline drugs were proposed according to the timing of its occurrence. It is divided into acute, subacute, chronic and late chronic. Since negative anticancer drugs impact on the human body can be irreversible, one of the most urgent tasks is its prevention. This is primary prevention of the development of cardiotoxicity. To date, data on the cardiotoxicity prevalence indicate that more than half of patients who have used anticancer antibiotics have various cardiovascular system dysfunctions. In recent RCTs, which were carried out in a several countries, it has been proven that the liposomal forms of drugs use reduces the cardiac changes risks. It was also found that the risk of their occurrence increases in direct proportion with an increase in the cumulative dose or with combined therapy with several drugs with antitumor activity. Therefore, the cardiotoxic effects prevention and correction are mandatory tasks for a every doctor. The aim of this research is to study and analyze scientific literature data on the prevalence, risk factors, mechanisms of development and outcomes of cardiotoxicity against the background of the use of antibiotics with antitumor activity.

The aim are to study the pathophysiology of the cardiotoxicity development, study the main cardiotoxic effects, as well as study various RCTs on a given topic.

Keywords:antibiotics, anthracyclines, doxorubicin, cardiotoxicity, cardiomyopathy, cancer therapy, trastuzumab, heart failure

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