Women Treated For Cancer at Risk For HF During, After Pregnancy
Young women previously treated for cancer with chemotherapy or radiation therapy with a prior history of cardiotoxicity may be more likely to develop clinical congestive heart failure (CHF) during and after pregnancy, according to a study published Oct. 15 in the Journal of the American College of Cardiology.
Paaladinesh Thavendiranathan, MD, SM, et al., followed 78 cancer survivors from a high-risk pregnancy clinic who had 94 pregnancies over a 10-year period. All the women had received cancer therapy as children, adolescents or young adults. Of the total women, 55 had received anthracycline-based chemotherapy, while 23 received non-anthracycline chemotherapy or radiation therapy only.
Of survivors exposed to anthracyclines, 13 women had a prior history of cardiotoxicity, and 12 of these women had been treated with anthracycline-based chemotherapy. During pregnancy or soon after delivery, CHF occurred in 31 percent of women with a history of cardiotoxicity, with no reports of acute coronary syndrome or arrhythmia. There was no difference in the age of cancer diagnosis, age at pregnancy, cancer type or exposure to anthracyclines between the women diagnosed with CHF and without. There were no maternal deaths.
"For women without a history of cardiotoxicity, their risk of developing CHF during pregnancy is very low," Thavendiranathan said. "However, for women who have been exposed to cardiotoxic treatments and have had prior cardiotoxicity, there's approximately a 1 in 3 chance of developing CHF with pregnancy. These women should receive close cardiac surveillance during pregnancy."
Keywords: Anthracyclines, Cardiotoxicity, Pregnancy, High-Risk, Acute Coronary Syndrome, Heart Failure, Arrhythmias, Cardiac, Neoplasms
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