title: Bevacizumab increases the incidence of cardiovascular events in patients with metastatic breast or colorectal cancer.
abstract: BACKGROUND
  The effect of systemic administration of bevacizumab in cancer patients over a 5-year period after the beginning of chemotherapy treatment and comparison with a control group.
  
  
  METHODS
  The study population consists of adult patients with metastatic breast or colorectal cancer who had not previously received antineoplasmatic treatment. Patients were stratified into two groups according to treatment: one group was treated with conventional chemotherapy plus bevacizumab and the other group was treated with conventional chemotherapy alone. The two groups did not differ in their cardiovascular history or demographic characteristics.
  
  
  RESULTS
  Fatal outcomes were more frequent in the bevacizumab group in total as well as in different periods of follow up. However, a statistically significant difference was noted at 12 months (P-value 0.007) for new deaths and at 24 (p-value 0.001) and 60 months (p-value 0.004) for all deaths. Moreover, patients who experienced a cardiovascular or thromboembolic event belonged exclusively to the bevacizumab group. At the 5-year follow-up, five patients in the bevacizumab group developed coronary artery disease (19.23%), four experienced an acute myocardial infarction (14.81%) and five patients suffered from a thromboembolic event (17.86%).
  
  
  CONCLUSIONS
  The addition of bevacizumab to conventional chemotherapy for metastatic breast or colorectal cancer increases the incidence of cardiovascular events, which is mainly due to the increased prevalence of myocardial infarction and thromboembolic events.
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kapelakis
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece. Electronic address: ktoutouz@gmail.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Drakopoulou
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Archontoula
authors.initials: A
authors.lastname: Michelongona
authors.affiliation: Department of Therapeutics, "Alexandra" Hospital, Athens Medical School, Athens, Greece.
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.affiliation: Department of Therapeutics, "Alexandra" Hospital, Athens Medical School, Athens, Greece.
authors.forename: Aristotle
authors.initials: A
authors.lastname: Mpamias
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Pliatsika
authors.affiliation: Department of Therapeutics, "Alexandra" Hospital, Athens Medical School, Athens, Greece.
authors.forename: Meletios-Athanasios
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use; D000068258:Bevacizumab / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology; D009362:Neoplasm Metastasis / Q000188:drug therapy* / Q000473:pathology; D015995:Prevalence; D013923:Thromboembolism / Q000150:complications / Q000453:epidemiology
chemical_list: D020533:Angiogenesis Inhibitors; D000074322:Antineoplastic Agents, Immunological; D000068258:Bevacizumab
keywords: Angiogenesis; Bevacizumab; Cancer; Coronary artery disease; Vascular endothelial growth factor