Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis

Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Jaime Pinho [verfasserIn] Miguel Carvalho [verfasserIn] Mariana Paiva [verfasserIn] Nuno Teixeira-Tavares [verfasserIn] Cristina Costa-Santos [verfasserIn] Carla Sousa [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch ; Portugiesisch

Erschienen:	2023

Schlagwörter:	Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia

Übergeordnetes Werk:	In: Revista Portuguesa de Cardiologia - Elsevier, 2020, 42(2023), 12, Seite 961-984
Übergeordnetes Werk:	volume:42 ; year:2023 ; number:12 ; pages:961-984

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.repc.2022.10.016

Katalog-ID:	DOAJ100594174

Internformat


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520			\|a Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados.
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allfields	10.1016/j.repc.2022.10.016 doi (DE-627)DOAJ100594174 (DE-599)DOAJbda256e945ff4b628c37b8ef6a642249 DE-627 ger DE-627 rakwb eng por RC666-701 Jaime Pinho verfasserin aut Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system Miguel Carvalho verfasserin aut Mariana Paiva verfasserin aut Nuno Teixeira-Tavares verfasserin aut Cristina Costa-Santos verfasserin aut Carla Sousa verfasserin aut In Revista Portuguesa de Cardiologia Elsevier, 2020 42(2023), 12, Seite 961-984 (DE-627)642886164 (DE-600)2586869-X 21742030 nnns volume:42 year:2023 number:12 pages:961-984 https://doi.org/10.1016/j.repc.2022.10.016 kostenfrei https://doaj.org/article/bda256e945ff4b628c37b8ef6a642249 kostenfrei http://www.sciencedirect.com/science/article/pii/S0870255123003530 kostenfrei https://doaj.org/toc/0870-2551 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 42 2023 12 961-984
spelling	10.1016/j.repc.2022.10.016 doi (DE-627)DOAJ100594174 (DE-599)DOAJbda256e945ff4b628c37b8ef6a642249 DE-627 ger DE-627 rakwb eng por RC666-701 Jaime Pinho verfasserin aut Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system Miguel Carvalho verfasserin aut Mariana Paiva verfasserin aut Nuno Teixeira-Tavares verfasserin aut Cristina Costa-Santos verfasserin aut Carla Sousa verfasserin aut In Revista Portuguesa de Cardiologia Elsevier, 2020 42(2023), 12, Seite 961-984 (DE-627)642886164 (DE-600)2586869-X 21742030 nnns volume:42 year:2023 number:12 pages:961-984 https://doi.org/10.1016/j.repc.2022.10.016 kostenfrei https://doaj.org/article/bda256e945ff4b628c37b8ef6a642249 kostenfrei http://www.sciencedirect.com/science/article/pii/S0870255123003530 kostenfrei https://doaj.org/toc/0870-2551 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 42 2023 12 961-984
allfields_unstemmed	10.1016/j.repc.2022.10.016 doi (DE-627)DOAJ100594174 (DE-599)DOAJbda256e945ff4b628c37b8ef6a642249 DE-627 ger DE-627 rakwb eng por RC666-701 Jaime Pinho verfasserin aut Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system Miguel Carvalho verfasserin aut Mariana Paiva verfasserin aut Nuno Teixeira-Tavares verfasserin aut Cristina Costa-Santos verfasserin aut Carla Sousa verfasserin aut In Revista Portuguesa de Cardiologia Elsevier, 2020 42(2023), 12, Seite 961-984 (DE-627)642886164 (DE-600)2586869-X 21742030 nnns volume:42 year:2023 number:12 pages:961-984 https://doi.org/10.1016/j.repc.2022.10.016 kostenfrei https://doaj.org/article/bda256e945ff4b628c37b8ef6a642249 kostenfrei http://www.sciencedirect.com/science/article/pii/S0870255123003530 kostenfrei https://doaj.org/toc/0870-2551 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 42 2023 12 961-984
allfieldsGer	10.1016/j.repc.2022.10.016 doi (DE-627)DOAJ100594174 (DE-599)DOAJbda256e945ff4b628c37b8ef6a642249 DE-627 ger DE-627 rakwb eng por RC666-701 Jaime Pinho verfasserin aut Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system Miguel Carvalho verfasserin aut Mariana Paiva verfasserin aut Nuno Teixeira-Tavares verfasserin aut Cristina Costa-Santos verfasserin aut Carla Sousa verfasserin aut In Revista Portuguesa de Cardiologia Elsevier, 2020 42(2023), 12, Seite 961-984 (DE-627)642886164 (DE-600)2586869-X 21742030 nnns volume:42 year:2023 number:12 pages:961-984 https://doi.org/10.1016/j.repc.2022.10.016 kostenfrei https://doaj.org/article/bda256e945ff4b628c37b8ef6a642249 kostenfrei http://www.sciencedirect.com/science/article/pii/S0870255123003530 kostenfrei https://doaj.org/toc/0870-2551 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 42 2023 12 961-984
allfieldsSound	10.1016/j.repc.2022.10.016 doi (DE-627)DOAJ100594174 (DE-599)DOAJbda256e945ff4b628c37b8ef6a642249 DE-627 ger DE-627 rakwb eng por RC666-701 Jaime Pinho verfasserin aut Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados. Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system Miguel Carvalho verfasserin aut Mariana Paiva verfasserin aut Nuno Teixeira-Tavares verfasserin aut Cristina Costa-Santos verfasserin aut Carla Sousa verfasserin aut In Revista Portuguesa de Cardiologia Elsevier, 2020 42(2023), 12, Seite 961-984 (DE-627)642886164 (DE-600)2586869-X 21742030 nnns volume:42 year:2023 number:12 pages:961-984 https://doi.org/10.1016/j.repc.2022.10.016 kostenfrei https://doaj.org/article/bda256e945ff4b628c37b8ef6a642249 kostenfrei http://www.sciencedirect.com/science/article/pii/S0870255123003530 kostenfrei https://doaj.org/toc/0870-2551 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 42 2023 12 961-984
language	English Portuguese
source	In Revista Portuguesa de Cardiologia 42(2023), 12, Seite 961-984 volume:42 year:2023 number:12 pages:961-984
sourceStr	In Revista Portuguesa de Cardiologia 42(2023), 12, Seite 961-984 volume:42 year:2023 number:12 pages:961-984
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia Diseases of the circulatory (Cardiovascular) system
isfreeaccess_bool	true
container_title	Revista Portuguesa de Cardiologia
authorswithroles_txt_mv	Jaime Pinho @@aut@@ Miguel Carvalho @@aut@@ Mariana Paiva @@aut@@ Nuno Teixeira-Tavares @@aut@@ Cristina Costa-Santos @@aut@@ Carla Sousa @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	642886164
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language_de	englisch portugiesisch
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A systematic review and meta-analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. 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author	Jaime Pinho
spellingShingle	Jaime Pinho misc RC666-701 misc Cancro da mama misc Cardiotoxicidade misc Quimioterapia misc Trastuzumab misc Dislipidemia misc Diseases of the circulatory (Cardiovascular) system Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis
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topic_title	RC666-701 Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis Cancro da mama Cardiotoxicidade Quimioterapia Trastuzumab Dislipidemia
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title	Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis
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title_full	Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis
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title_sort	is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? a systematic review and meta-analysis
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title_auth	Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis
abstract	Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados.
abstractGer	Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados.
abstract_unstemmed	Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados.
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title_short	Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis
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A systematic review and meta-analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. Methods: The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. Results: A total of 39 studies were selected for inclusion in our systematic review assessing 21 079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22–4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01–1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73–1.10, p=0.28, I2=0%). Conclusion: This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results. Resumo: Introdução: Pacientes com cancro da mama sob tratamento com trastuzumab apresentam maior risco de doença cardiovascular. Fatores de risco têm sido propostos. No entanto, o papel da dislipidemia não é completamente conhecido. Esta revisão sistemática destinou-se a explorar o papel da dislipidemia na cardiotoxicidade induzida por trastuzumab. Métodos: Os investigadores pesquisaram publicações na MEDLINE, Scopus e Web of Science até 25 de outubro de 2020. Um modelo de efeitos aleatórios foi utilizado para determinar as estimativas combinadas dos resultados. A variável de resultado primária foi a cardiotoxicidade induzida por trastuzumab em pacientes com e sem dislipidemia. Resultados: Foram selecionados 39 estudos para inclusão na nossa revisão sistemática, avaliando 21.079 pacientes. Um estudo demonstrou associação significativa entre dislipidemia e cardiotoxicidade (OR=2,28, 95% CI=1,22-4,26, p=0,01). Em todos os restantes não foram observadas semelhantes associações. Foram elegíveis 21 estudos para a meta-análise incluindo 6135 pacientes. Na meta-análise de dados não ajustados a dislipidemia esteve associada significativamente a cardiotoxicidade (OR=1,25, 95% CI=1,01-1,53, p=0,04, I2=0%). No entanto, a análise de subgrupos de estudos que reportaram as medidas ajustadas não demonstrou uma associação significativa (OR=0,89, 95% CI=0,73-1,10, p=0,28, I2=0%). Conclusão: Esta revisão sistemática e meta-análise não demonstrou uma associação significativa entre dislipidemia isolada e o desenvolvimento de cardiotoxicidade. Na ausência de outros fatores de risco cardiovasculares relevantes, a análise do perfil lipídico nestes pacientes pode não ser obrigatória e a vigilância poderá ser realizada sem referenciação para avaliação por cardio-oncologia. Investigação adicional sobre fatores de risco para cardiotoxicidade induzida por trastuzumab é necessária para confirmar estes resultados.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Cancro da mama</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Cardiotoxicidade</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Quimioterapia</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Trastuzumab</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Dislipidemia</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the circulatory (Cardiovascular) system</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Miguel Carvalho</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Mariana 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Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis

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