Role of HDL cholesterol in anthracycline-induced subclinical cardiotoxicity : a prospective observational study in patients with diffuse large B-cell lymphoma treated with R-CHOP
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: Anthracycline-induced cardiotoxicity is a debilitating cardiac dysfunction for which there are no effective treatments, making early prevention of anthracycline-induced subclinical cardiotoxicity (AISC) crucial. High-density lipoprotein cholesterol (HDL-C) plays a role in cardioprotection, but its impact on AISC remains unclear. Our study aims to elucidate the protective capacity of HDL-C in AISC in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone and rituximab).
DESIGN: Prospective observational study.
SETTING: Conducted in China from September 2020 to September 2022.
PARTICIPANTS: 70 chemotherapy-naïve patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case-control study (DOI: 10.1186/s12885-022-10085-6).
PRIMARY OUTCOME MEASURES: Serum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy.
RESULTS: 24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52±0.49 vs 1.22±0.29, p=0.034).
CONCLUSIONS: Our study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations.
STUDY REGISTRATION NUMBER: Study registration number: ChiCTR2100054721.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
BMJ open - 14(2024), 2 vom: 10. Feb., Seite e074541 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ou, Wenxin [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.02.2024 Date Revised 23.02.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2023-074541 |
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| Förderinstitution / Projekttitel: |
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NLM368307166 |
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| 100 | 1 | |a Ou, Wenxin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Role of HDL cholesterol in anthracycline-induced subclinical cardiotoxicity |b a prospective observational study in patients with diffuse large B-cell lymphoma treated with R-CHOP |
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| 500 | |a Date Revised 23.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: Anthracycline-induced cardiotoxicity is a debilitating cardiac dysfunction for which there are no effective treatments, making early prevention of anthracycline-induced subclinical cardiotoxicity (AISC) crucial. High-density lipoprotein cholesterol (HDL-C) plays a role in cardioprotection, but its impact on AISC remains unclear. Our study aims to elucidate the protective capacity of HDL-C in AISC in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone and rituximab) | ||
| 520 | |a DESIGN: Prospective observational study | ||
| 520 | |a SETTING: Conducted in China from September 2020 to September 2022 | ||
| 520 | |a PARTICIPANTS: 70 chemotherapy-naïve patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case-control study (DOI: 10.1186/s12885-022-10085-6) | ||
| 520 | |a PRIMARY OUTCOME MEASURES: Serum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy | ||
| 520 | |a RESULTS: 24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52±0.49 vs 1.22±0.29, p=0.034) | ||
| 520 | |a CONCLUSIONS: Our study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations | ||
| 520 | |a STUDY REGISTRATION NUMBER: Study registration number: ChiCTR2100054721 | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CARDIOLOGY | |
| 650 | 4 | |a CHEMOTHERAPY | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Lymphoma | |
| 650 | 7 | |a Anthracyclines |2 NLM | |
| 650 | 7 | |a Antibiotics, Antineoplastic |2 NLM | |
| 650 | 7 | |a Azides |2 NLM | |
| 650 | 7 | |a azidoiodophenethylamidosuccinylcymarin |2 NLM | |
| 650 | 7 | |a 117751-59-4 |2 NLM | |
| 650 | 7 | |a Cholesterol, HDL |2 NLM | |
| 650 | 7 | |a Cyclophosphamide |2 NLM | |
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| 650 | 7 | |a Cymarine |2 NLM | |
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| 650 | 7 | |a Doxorubicin |2 NLM | |
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| 650 | 7 | |a Prednisone |2 NLM | |
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| 650 | 7 | |a Rituximab |2 NLM | |
| 650 | 7 | |a 4F4X42SYQ6 |2 NLM | |
| 650 | 7 | |a Vincristine |2 NLM | |
| 650 | 7 | |a 5J49Q6B70F |2 NLM | |
| 700 | 1 | |a Jiang, Tiantian |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Nan |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Kai |e verfasserin |4 aut | |
| 700 | 1 | |a Weng, Yue |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Xi |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Dong, Qian |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Xiaoqiong |e verfasserin |4 aut | |
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