Predictive value of electrocardiogram to trastuzumab-mediated cardiotoxity

XUE Jian; JIN Xin; YU Nong; ZHANG Xiao-zhong

doi:10.3969/j.1674-4055.2014.06.11

Abstract：Objective To discuss the predictive value of electrocardiogram (ECG) to trastuzumab-mediated cardiotoxity.Methods The female patients (n=199, average age: 47.47±10.20) with HER2-positive early breast cancer treated with adjuvant trastuzumab therapy were chosen from Jan. 2008 to Jan. 2013. The changes of heart function were observed, and the patients were divided into cardiotoxity group and non-cardiotoxity group. The correlation between abnormal ECG and cardiotoxity was analyzed, and predictive value of ECG to trastuzumab-mediated cardiotoxity was reviewed.Results The eligible cardiotoxity events were in succession occurred in totally 42 patients (21.11%). Compared with non-cardiotoxity group, the percentage of patients with abnormal ECG increased in cardiotoxity group (59.24%vs. 73.81%,P<0.01). From the beginning of the 2nd therapeutic circle, the percentage of patients with abnormal ECG increased significantly in cardiotoxity group compared with non-cardiotoxity group (P<0.05). The risk of cardiotoxity increased by 1.7 times in the patients with 1-time abnormal ECG (HR=1.762, 95%CI:0.914~3.793), and increased by 2.8 times in those with 2-time abnormal ECG (HR=2.881, 96%CI:1.461~5.679). The sensitivity and specificity of 1-time abnormal ECG for predicting cardiotoxity were, respectively, 73% and 41%, and those of 2-time abnormal ECG for predicting cardiotoxity were, respectively, 69% and 58%. The specificity of 5-time or more abnormal ECG for predicting cardiotoxity was as high as 83%.Conclusion ECG has higher sensitivity for finding subclinical cardiotoxity, which maybe one of ideal approaches for monitoring cardiotoxity occurrence in patients with tumor.