Risk factors for cardiovascular toxicity in women with breast cancer

The development of preventive measures aimed at reducing the risk of cardiovascular toxicity (CVT) and cardiovascular complications in cancer patients is in line with the 5P medicine development strategy approved by the State Program for the Socio-Economic Development of the Republic of Belarus for 2026–2030.
The aim of the study was to determine the prevalence of cardiovascular risk factors in women with breast cancer (BC) and to evaluate the impact of comprehensive treatment of this disease on the cardiovascular system. A prospective singlecenter study was conducted involving 98 women with BC. According to the HFA-ICOS scale, 76.5 % of patients had a low risk and 23.5 % had a moderate risk of developing CVT. A positive family history of cardiovascular disease was identified in 24.5 % of women with BC, dyslipidemia in 54.1 %, arterial hypertension (AH) in 19.4 %, 21.4 % had obesity, and 6.1 % and 33.7 % were active and passive smokers, respectively. In BC patients who did not receive cardiotropic therapy, completion of anticancer treatment was associated with: a decrease in left ventricular ejection fraction (p < 0.001), a reduction in the ratio of early to late transmitral flow velocities (E/A) (p = 0.005), a reduction in the ratio of early to late mitral annular velocities (eʹ/aʹ) (p < 0.001), an increase in intima-media thickness at the carotid bifurcation (p = 0.041), a decrease in endothelium-dependent dilation of the brachial artery (p = 0.018) and aldosterone levels (p = 0.012), as well as an increase in plasma B-type natriuretic peptide (BNP) (p = 0.029) and total nitric oxide (p = 0.04). It has been established that comprehensive treatment of BC in women with low to moderate risk of CVT leads to subclinical changes in the cardiovascular system. Prescribing a combination of valsartan and carvedilol is an effective method of medical prevention of CVT in this category of patients.

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