Analysis Of Relative Risk Factors For Electrocardiographic Abnormality Induced By Anthracyclines

Objective:To retrospectively analyze the clinical characteristics of electrocardiogram(ECG)in breast cancer patients treated with anthracyclines chemotherapy,and ECG changes in the patients with neoadjuvant anthracyclines chemotherapy during the perioperative operation.To investigate the relative risk factors for ECG abnormalities induced by anthracyclines in breast cancer patients.Methods:266 patients with newly diagnosed breast cancer were selected in Affiliated Cancer Hospital of Guangxi Medical University from July 2015 to April 2017.According to whether ECG abnormalities in the patients after anthracyclines chemotherapy,all cases were divided into two groups(Group with ECG abnormalities and Group with no ECG abnormalities),and the incidence of ECG abnormalities were summarized.This experiment analyzed the relationship between ECG abnormalities and serum cTnI level after anthracyclines chemotherapy in two groups,and the relationship with the relative factors(age,BMI,tumor staging,and the history of hypertension,diabetes,hyperlipidemia,and the type and cumulative dose of anthracyclines,cardioprotective drug),and T wave change of ECG in two groups.We analyzed the correlation between ECG changes after anthracyclines chemotherapy and the relative risk factors in breast cancer patients,and the effect of neoadjuvant chemotherapy combined with general anesthesia on perioperative ECG changes in some cases.Results:(1)104 cases of 266 breast cancer patients were abnormal in ECG and the incidence was 39.09%.The main manifestations were listed as follows:27 cases with sinus tachycardia and the incidence was 10.15%;9 cases with sinus bradycardia and the incidence was 3.38%;8 cases with atrial extrasystole and the incidence was 3.01%;13 cases with ventricular contractions and the incidence was 4.88%;3 cases with short PR interval and the incidence was1.13%;10 cases with ST segment and the incidence was 3.76%;52 cases with T wave and the incidence was 19.55%;1 case with atrioventricular block and the incidence was 0.37%;6 cases with bundle branch block and the incidence was2.26%.(2)The differences of ECG abnormality were statistically significant between anthracyclines cumulative doses(doses≥300mg/m~2 of pirarubicin,THP,or doses≥500mg/m~2 of epirubicin,EPI)(P<0.05).The differences of ECG abnormality were statistically significant anthracyclines between the cases that unused dexrazoxane(P<0.05).High cumulative dose of anthracyclines were independent risk factors of ECG abnormalities in the patients.Dexrazoxane administration had protective effect on cases with ECG abnormalities that induced by anthracyclines.(3)The correlation no significant difference between ECG abnormalities and serum cTnI level after anthracyclines chemotherapy in the cases of two groups(P>0.05).(4)The cases with anthracyclines chemotherapy administration had a correlation on the ECG abnormalities in the perioperative period with general anesthesia(P<0.05).Conclusion:(1)The incidence of ECG abnormalities in the patients afteranthracyclines chemotherapy administration can be find quite frequently,and the highest incidence were T wave change of ECG in all cases.(2)High cumulative dose of anthracyclines chemotherapy(dose≥300mg/m~2 of THP,or≥500mg/m~2of EPI)were related with ECG abnormalities.(3)Dexrazoxane administration had a protective effect on ECG abnormalities in the patients that induced by anthracyclines chemotherapy.(4)Anthracyclines chemotherapy administration had effects on ECG abnormalities in the perioperative period with general anesthesia.