Analysis Of Influencing Factors Of Cardiovascular Adverse Events In Patients With Lung Cancer Chemotherapy

Objective To identify the factors influencing the occurrence of cardiovascular adverse events(CVAEs)in lung cancer chemotherapy patients and to analyze the predictive value of independent risk factors for the occurrence of CVAEs in patients with lung cancer chemotherapy.Methods Patients admitted to the respiratory department of Gansu Provincial Hospital from June2018 to June 2022 with diagnosis of primary lung cancer were retrieved using the system of online medical records.Following the application of inclusion and exclusion criteria,328 patients were included in this study,and baseline data,laboratory indices,electrocardiographic parameters and transthoracic echocardiographic indices were collected from all study subjects.The patients were divided into normal and CVAEs groups according to whether CVAEs occurred during the 6 cycles of drug therapy.The differences between the baseline data,laboratory parameters,ECG parameters and transthoracic echocardiographic indices of patients in different groups were compared,and logistic regression was applied to analyze the factors influencing the occurrence of CVAEs in patients with lung cancer chemotherapy.Neutrophil lymphocyte ratio(NLR),QTc interval,left ventricular end diastolic diameter(LVEDD)were analysis of the subject work’s characteristic curve(ROC)was used.The predictive value of the combination of the three indices for the development of CVAEs in patients with lung cancer chemotherapy.Results1.The 328 patients were included in this study,221(67.38%)were male.77(23.48%)patients had CVAEs,including 50 cases of arrhythmias(27 cases of atrioventricular block,9 cases of frequent premature ventricular beats,10 cases of frequent premature atrial beats,and 4 cases of atrial fibrillation)and 15 cases of heart failure(1 case of reserved ejection fraction,12 cases of intermediate ejection fraction,2 cases of reduced ejection fraction),3 cases of coronary atherosclerotic heart disease(2 cases of stable angina,1 case of unstable angina),4 cases of newonset hypertension,and 5 cases of lower limb venous thrombosis.2.The proportion of patients who smoked,NLR,N-terminal pro-brain natriuretic peptide(NTpro BNP)(≥50 pg/ml),QTc interval,and LVEDD were higher in the CVAEs group than in the normal group(P < 0.05).The risk of CVAEs was higher in patients receiving platinum combined with target-free drugs than in those receiving platinum only,and the variance was statistically significant(P < 0.05).Binary logistic regression analysis demonstrated that chemotherapy regimen,NLR,QTc,and LVEDD were independent risk factors for the development of CVAEs in lung cancer chemotherapy patients.The results show that the area under the ROC curve is3.The results of analysis of the ROC curve revealed that the AUC of QTc interval combined with NLR and LVEDD was 0.868,95% CI was 0.820-0.916,the sensitivity was 78.6%,and the specificity was 81.1%,and the AUC,sensitivity,and specificity were better than the individual indexes of QTc interval,NLR,and LVEDD.Conclusion1.The incidence of CVAEs in lung cancer chemotherapy patients was 23.48%,and the proportion of males was higher than females.2.Chemotherapy regimen,NLR,QTc interval,and LVEDD were independent risk factors for cardiovascular events in patients with lung cancer chemotherapy.3.Baseline QTc interval combined with NLR and LVEDD was the best predictor for the occurrence of CVAEs with an AUC value of 0.868,95% CI of 0.820 to 0.916,sensitivity of 78.6%,and specificity of 81.1%.