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A Prospective Study to Evaluate the Effect of Paclitaxel on Cardiac Ejection Fraction
Author(s) -
Mohammed A. Osman,
Mohammad Sabry Elkady
Publication year - 2017
Publication title -
breast care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.767
H-Index - 30
eISSN - 1661-3805
pISSN - 1661-3791
DOI - 10.1159/000471759
Subject(s) - medicine , ejection fraction , cardiotoxicity , paclitaxel , prospective cohort study , confidence interval , diabetes mellitus , cardiac toxicity , cardiac function curve , cardiology , chemotherapy , heart failure , endocrinology
Background: The primary objective of the study was to evaluate the long-term changes in ejection fraction (EF) associated with paclitaxel infusion. Methods: 50 patients were enrolled in this prospective study between 2011 and 2015. The study design included frequent follow-up visits to the clinic, EF evaluation at baseline, and regular EF assessment by echocardiography for 30 months after treatment. Results: The median baseline EF was 60% (95% confidence interval (CI) 50-80%). At 30 months, the median EF was 48% (95% CI 40-60%; p = 0.03). During the 30-month follow-up, 10 (20%) patients developed grade 1 and 2 cardiotoxicities; none developed grade 3 or 4 cardiotoxicities. Furthermore, paclitaxel cardiotoxicity increased among patients with high-risk features including associated diabetes mellitus, hypertension, prior radiotherapy to the chest wall, performance status of 2, and age > 60 years. Conclusion: Paclitaxel has cardiotoxic effects. Careful monitoring of cardiac function during and after paclitaxel infusion is required in patients with high-risk features.

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