Open AccessCytotoxic-induced heart failure among breast cancer patients in Nigeria: A call to prevent today's cancer patients from being tomorrow's cardiac patients
Author(s) -
Raphael Anakwue
Publication year - 2020
Publication title -
annals of african medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.433
H-Index - 26
ISSN - 1596-3519
DOI - 10.4103/aam.aam_24_19
Subject(s) - medicine , cardiotoxicity , breast cancer , heart failure , cyclophosphamide , anthracycline , ejection fraction , cytotoxic t cell , cancer , trastuzumab , cardiology , intensive care medicine , chemotherapy , oncology , biochemistry , chemistry , in vitro
We report three cases of heart failure (HF) associated with the use of cytotoxic drugs such as anthracycline, cyclophosphamide, and 5-fluorouracil in the treatment of breast cancer in Nigerians. The patients had systolic and diastolic HF: HF with reduced ejection fraction and preserved ejection fraction. The prevalence of breast cancer is increasing across Africa, and cytotoxics are some of the most common and best drugs used during management. The cardiotoxicity caused by these drugs limits their use as chemotherapeutic agents. Cytotoxic-induced HF is a preventable and manageable cause of cardiovascular disease (CVD) in Nigeria and Africa. This article discusses the pathophysiology of cytotoxic-induced HF and presents the risk factors that impair cardiovascular function. The importance of proper assessment and the prophylactic and therapeutic measures in the management of cytotoxic-induced HF are emphasized. The peculiar challenges in the management of cytotoxic-induced HF in Nigeria were also discussed. The need for early involvement of cardiologists by oncologists to improve on the chemotherapeutic and cardiovascular outcome in the management of patients with breast cancer was stressed. Perhaps, it is time to birth a new discipline of cardiooncology in Nigeria.