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Cardiotoxic Profile and Arterial Stiffness of Adjuvant Chemotherapy for Colorectal Cancer

Authors Visvikis A, Kyvelou SM, Pietri P, Georgakopoulos C, Manousou K, Tousoulis D, Stefanadis C, Vlachopoulos C, Pektasides D

Received 12 July 2019

Accepted for publication 3 October 2019

Published 13 February 2020 Volume 2020:12 Pages 1175—1185

DOI https://doi.org/10.2147/CMAR.S223032

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


A Visvikis,1 SM Kyvelou,2 P Pietri,2 C Georgakopoulos,2 K Manousou,1 D Tousoulis,2 C Stefanadis,2 C Vlachopoulos,2 D Pektasides3

1Third Department of Medical Oncology, Agioi Anargyroi General Oncology Hospital of Kifissia, Athens, Greece; 2Cardiology Department, First Cardiology Clinic, Athens Medical School, Hippokration Hospital, Athens, Greece; 3Second Department of Internal Medicine, School of Medicine, University of Athens, Athens, Greece

Correspondence: SM Kyvelou
Cardiology Department, First Cardiology Clinic, Athens Medical School, Hippokration Hospital, Perikelous 97B, Kato Xalandri, Athens 15231, Greece
Tel +30 697283751
Email smkyvel@gmail.com

Background and Purpose: Even though new cancer therapies have improved the overall survival, in some cases they have been associated with adverse effects, including increased cardiotoxicity. The purpose of the present study was to assess the cardiovascular effects of adjuvant chemotherapy for colorectal cancer and mainly the impact on arterial stiffness indices.
Material and Methods: A total of 70 patients with non-metastatic colorectal cancer who were treated either with FOLFOX (n=16) or with XELOX (n=54) adjuvant chemotherapy were included in the study. All patients were subjected to full cardiovascular evaluation at the beginning and the end of chemotherapy. Arterial stiffness was assessed by means of pulse wave velocity (PWV) and augmentation index (Aix) and full laboratory examinations were conducted prior to, and soon after, the termination of chemotherapy.
Results: Patients exhibited significantly higher levels of carotid-radial PWV, carotid femoral RWV and Aix post-chemotherapy (p< 0.001); these findings remained significant when examined separately in each treatment subgroup (FOLFOX, XELOX). The observed changes were independent of treatment regimen and baseline patient characteristics. Univariate regression analyses showed that baseline PWVc-r and PWVc-f were the only factors associated with PWVc-r and PWVc-f change, while Aix change was independent of its baseline value.
Conclusion: There is a clear burden in arterial stiffness indices post-adjuvant chemotherapy for colorectal cancer in both chemotherapy groups. This is a finding of important clinical significance, however more prospective studies are required in order to encode the possible mechanisms involved.

Keywords: arterial stiffness, adjuvant chemotherapy, colorectal cancer


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