title: Risk factors for developing cardiotoxicity of trastuzumab in breast cancer patients: An observational single-centre study.
abstract: BACKGROUND
  Trastuzumab is a recombinant humanized monoclonal antibody used to treat human epidermal growth factor receptor 2 positive breast cancer, with recognized associated cardiotoxicity. In this retrospective observational study, we investigated associated cardiotoxicity on clinical outcomes using trastuzumab in women referred to our clinic.
  
  
  METHODS
  The study was made up of 111 women with human epidermal growth factor receptor 2-overexpressing breast cancer who received trastuzumab in the Medical Oncology Department, between 2010 and 2013.
  
  
  RESULTS
  A > 10% reduction of the baseline fraction of the left ventricular ejection fraction was observed in 18 (16.21%) women. Two individuals (1.8%) suffered from symptomatic heart failure, seven women showed cardiac symptoms and nine women showed asymptomatic decline of left ventricular ejection fraction. Risk factors for cardiotoxicity in the group included: postmenopausal status (p = 0.01), hypertension (p = 0.002), obesity (p = 0.0001), previously diagnosed coronary artery disease (p = 0.0001) and smoking (p = 0.03).
  
  
  CONCLUSIONS
  The aforementioned factors pose a risk for cardiotoxicity. We found postmenopausal status, hypertension, obesity, previous coronary artery disease and smoking to be associated with an increased risk of cardiac dysfunction in women using trastuzumab. While administering trastuzumab to women who have these conditions, one must be aware of the risk of cardiotoxicity of trastuzumab.
authors.affiliation: Department of Medical Oncology, Bakirkoy Research and Training Hospital, Istanbul, Turkey meralgunaldi@gmail.com.
authors.forename: Meral
authors.initials: M
authors.lastname: Gunaldi
authors.affiliation: Department of Medical Oncology, Adana Research and Training Hospital, Istanbul, Turkey.
authors.forename: Berna Bozkurt
authors.initials: BB
authors.lastname: Duman
authors.affiliation: Department of Medical Oncology, Cukurova University Medical School, Istanbul, Turkey.
authors.forename: Cigdem Usul
authors.initials: CU
authors.lastname: Afsar
authors.affiliation: Department of Medical Oncology, Cukurova University Medical School, Istanbul, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Paydas
authors.affiliation: Department of Medical Oncology, Cukurova University Medical School, Istanbul, Turkey.
authors.forename: Melek
authors.initials: M
authors.lastname: Erkisi
authors.affiliation: Department of Medical Oncology, Cukurova University Medical School, Istanbul, Turkey.
authors.forename: I Oguz
authors.initials: IO
authors.lastname: Kara
authors.affiliation: Department of Medical Oncology, Cukurova University Medical School, Istanbul, Turkey.
authors.forename: Berksoy
authors.initials: B
authors.lastname: Sahin
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D066126:Cardiotoxicity; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D000068878:Trastuzumab / Q000009:adverse effects*; D014421:Turkey / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Trastuzumab; breast cancer; cardiotoxicity; onco-pharmacology; risk factors