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Doxorubicin is chemotherapeutic agent in the standard regimen for the treatment of breast cancer. The major adverse drug reaction is cardiotoxicity. This study aimed to determine the incidence and risk-factors of congestive heart failure (CHF) in breast cancer patients treated with doxorubicin at Phrachomklao Hospital. Methods: This was a 10-year retrospective study of breast cancer patients treated with doxorubicin at Phrachomklao Hospital from January 1, 2008 to December 31, 2018. The data was collected from electronic medical records (EMR). A logistic regression analysis was used to determine factors associated with the development of CHF. Result: Two hundred thirteen patients were prescribed 574 doses of doxorubicin. The incidence of doxorubicin-induced congestive heart failure was 5.6% (12 cases, 0.0209 events per patient-dose of exposure), seven patients (3.29%) developed early-onset congestive heart failure and 5 patients (2.33%) developed late-onset congestive heart failure. The only significant risk factor for CHF was cumulative dose of doxorubicin. A cumulative dose over 300 mg/mm2 showed higher incidence of CHF compared to lower cumulative dose (< 300 mg/m2) (RR 4.48, 95% CI; 1.30-15.45, p= 0.01). The risk of CHF in patients undergoing hormone therapy was lower. Conclusion: The incidence of doxorubicin-induced CHF in breast cancer patients treated with doxorubicin at Phrachomklao Hospital was 5.6% within the first year. A cumulative dose greater than 300 mg/mm2 was a significant risk factor for developing heart failure. Close monitoring of cardiotoxicity should be performed in high risk patients, especially during the first year post treatment.
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