Factors Predicting Cardiotoxicity of Chemotherapy in Breast Cancer Patients at 1 Year
Keywords:
cardiotoxicity, breast cancer, health behavior, neighborhood, health literacyAbstract
The objective of this study was to investigate the predictive power of age, comorbidities, educational level, health behaviors, residential area, and health literacy on the occurrence of cardiotoxicity within one year of chemotherapy in breast cancer patients.
A total of 136 breast cancer patients who had completed 1 year of chemotherapy were recruited. Data were collected using structured questionnaires covering personal and clinical information, health behaviors, residential area, and health literacy. The quality of the instruments was assessed using Cronbach’s alpha coefficients, which were .97, .85 and .85 respectively. Data analysis was conducted using binary logistic regression. The findings revealed that age was a statistically significant predictor of cardiotoxicity. Specifically, increasing age was associated with a 1.088-fold increase in the likelihood of developing cardiotoxicity (OR = 1.088, 95% CI: 1.021–1.160, p < .05). The findings of this study can be utilized as a basis for surveillance and reduction of the incidence of chemotherapy-induced cardiotoxicity. Furthermore, they serve as foundational nursing information for promoting patients’ knowledge and understanding of the disease, including the potential signs and symptoms of cardiotoxicity.
Downloads
References
World Health Organization. Global recommendations on physical activity for health. Geneva: World Health Organization; 2020
Wongpimon B & Uamtanee A. Caring for chemotherapy patients by nurse: a qualitative study. Journal of The Royal Thai Army Nurses. 2017;18(2):229–38. (in Thai)
Cardinale D, Colombo A, Bacchiani G, Tedeschi I, Meroni CA, Veglia F, et al. Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation. Cancer Research. 2015;131(22):1981–8.
National Cancer Institute Surveillance Epidemiology and End Results Program (SEER) Cancer Statistics. Bethesda (MD): National Cancer Institute; 2019.
European Society of Cardiology (ESC). Guidelines for atrial fibrillation; 2020.
Cholthicha T. Introduction to cardio-oncology: Anthracycline-induced cardiotoxicity. Chulabhorn Royal Academy Journal. 2021; 3(2):71-9. (in Thai)
Boekel NB, Duane FK, Jacobse JN, Hauptmann M, Schaapveld M, Sonke GS, et al. Heart failure after treatment for breast cancer. European Journal of Heart Failure. 2020;22(2):366–74.
Clark R, Thompson R,& Johnson P. The impact of comorbidities on breast cancer outcomes: A population-based study. Cancer Research. 2017;123(12):2436-45.
Chung I, Lee J, Moon H, Shin K, Han W,& Son B. Effect of standard low-dose anthracycline chemotherapy on late congestive heart failure in breast cancer survivors aged between 50 and 59 at diagnosis: A nationwide study. The Breast Journal. 2020; 53:125–9.
Farolfi A, Melegari E, Aquilina M, Scarpi E, Ibrahim T, Maltoni R, et al. Trastuzumabinduced cardiotoxicity in early breast cancer patients: a retrospective study of possible risk and protective factors. Journal of Heart Failure. 2013;99(9):634-9.
Jacqueline H, Miller R, & Smith T. Quality of life in breast cancer survivors with heart failure. European Journal of Cancer care. 2017; 123(4):985-93
Harrison BT & Dillon DA. An update of mucinous lesions of the breast. Surgical Pathology Clinics. 2018;11(1):61-90.
Prachuab-Aree & Ketueam. Retrospective study on cardiotoxicity of doxorubicin in breast cancer patients at Phrachomklao Hospital, Phetchaburi Province. Isan Journal of Pharmaceutical Sciences. 2021;17(2):68–79. (in Thai)
Kanu C. Exploring barriers to breast cancer care among African women. Cancer Nursing. 2021;44(1):58-65.
Office of Disease Prevention and Health Promotion. Social determinants of health. Washington, DC: U.S. Department of Health and Human Services; 2020.
World Health Organization. A conceptual framework for action on the social determinants of health: World Health Organization;2010.
Peduzzi P, Concato J, Kemper E, Holford T, & Feinstein R. A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Oncology Epidemiology. 1996;49(12):1373-81.
Borson S, Scanlan J, Brush M, Vitaliano P,& Dokmak A. The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. International Journal Geriatratric Psychiatry 2000;15(11):1021-9.
Trongsakul S, Lambert R, Clark A, Wongpakaran N,& Cross J. Development of the Thai version of Mini-Cog, a brief cognitive screening test. Geriatr Gerontol International. 2015;15(5): 594-600. (in Thai)
Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Consortium Health Literacy Project European (HLS-EU). Health literacy and public health: a systematic review and integration of definitions and models. BioMed Central Public Health. 2012; 12:80.
Unphrommee S, Deeroem K,& Homsombat Y. Health literacy of elderly people in Nakhon Ratchasima province. The Journal Health Promotion Environ Health. 2020;14(33):188-95. (in Thai)
Song H, Lee S,& Kim J. Development and validation of the Cardiac Health Behavior Scale. Journal of Cardiovascular Nursing. 2018;33(6):537-44.
Detkaew A & Samartkit N. Factors influencing
health behaviors in adults with acute coronary syndrome post percutaneous coronary intervention. Chonburi: Burapha University; 2021. (in Thai)
Auchincloss H, Diez Roux V, Brown G, Erdmann C,& Bertoni A. Neighborhood resources for physical activity and healthy foods and their association with insulin resistance. Epidemiology. 2008;19(1):146-57.
Jaiyungyuen U, Suwonnaroop N, Priyatruk P, & Moopayak K. Factors influencing healthpromoting behaviors of older people with hypertension. 1stMae Fah Luang University International Conference; 2012. (in Thai)
American Heart Association. High blood pressure and cardiovascular disease risk. Dallas (TX): American Heart Association; 2020.
American Society of Clinical Oncology. Anthracycline chemotherapy information. Alexandria (VA): American Society of Clinical Oncology; 2021.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Journal of The Royal Thai Army Nurses
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหรือข้อคิดเห็นใดใดที่ปรากฏในวารสารพยาบาลทหารบกเป็นวรรณกรรมของผู้เขียน ซึ่งบรรณาธิการหรือสมาคมพยาบาลทหารบก ไม่จำเป็นต้องเห็นด้วย
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลทหารบก
The ideas and opinions expressed in the Journal of The Royal Thai Army Nurses are those of the authors and not necessarily those
of the editor or Royal Thai Army Nurses Association.
