Myocardial infarction and other major vascular events during chemotherapy for testicular cancer.
BACKGROUND
Chronic vascular morbidity resulting from chemotherapy for testicular germ-cell cancer (TGCC) is recognized. Cardiovascular events (CVEs) occurring early during chemotherapy are less understood. We evaluated the incidence and clinical features of CVEs associated with chemotherapy of TGCC.


METHODS
A questionnaire was sent to 355 institutions in Germany to explore for early CVEs occurring during 1996-2008. To assess the relative incidence of CVEs, the number of events was put into relation to the total number of patients treated during the time span (n = 8233, calculated from national database). The response rate was 79%.


RESULTS
Twenty cases with myocardial infarction (MI), 3 with cerebral stroke, and 2 with arterial thrombosis were recorded. The estimated incidence of MI and of all CVEs during chemotherapy is 0.24% [95% confidence intervals (CIs) 0.137% to 0.349%] and 0.30% (95% CI 0.188% to 0.423%), respectively. This estimate represents a minimum figure because the calculation is on the basis of simplifications. Six MI patients had no risk factors. Coronary angiography was indicative of thromboembolic rather than atherosclerotic origin of MI.


CONCLUSIONS
There is a small but definite risk of major early CVE associated with chemotherapy of TGCC. Physicians caring for TGCC patients must be aware of this hazard.
Dieckmann
K-P
KP
Department of Urology, Albertinen-Krankenhaus Hamburg, Hamburg. Electronic address: DieckmannKP@t-online.de.
Gerl
A
A
Onkologische Schwerpunktpraxis München, Munich.
Witt
J
J
Department of Cardiology, Albertinen-Krankenhaus Hamburg, Hamburg.
Hartmann
J-T
JT
Department of Medical Oncology, II. Medizinische Klinik und Poliklinik, Universitätsklinik Tübingen, Tübingen, Germany.
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced*; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000188:drug therapy*; D014652:Vascular Diseases / Q000139:chemically induced*
D000970:Antineoplastic Agents