THE IMPACT OF BORTEZOMIB-CONTAINING CHEMOTHERAPY REGIMEN ON MYOCARDIAL BIOELECTRICAL ACTIVITY IN PATIENTS WITH MULTIPLE MYELOMA AND CONCOMITANT CORONARY ARTERY DISEASE

Abstract

Introduction. The mortality rate in oncology has been steadily decreasing since the 1990s, leading to increased life expectancy among cancer survivors. However, chemotherapy-related toxicity, including cardiotoxicity, remains a concern in the selection of chemotherapy drugs. Multiple myeloma, a type of cancer, has increased in prevalence and morbidity rates in recent decades. The specific treatments for multiple myeloma can have cardiotoxic effects, such as arterial hypertension, heart failure, acute coronary syndrome, and heart rhythm and conductivity disorders.
 Objective. This study aims at investigating the unique characteristics of myocardial bioelectric activity in patients with progressive multiple myeloma and concomitant coronary artery disease undergoing bortezomib-containing chemotherapy.
 Materials and Methods. A total of 42 multiple myeloma patients were examined, 22 (52.5%) of them were diagnosed to have concomitant coronary artery disease. Patients were divided into two groups based on the presence of coronary artery disease. All patients received bortezomib-containing chemotherapy regimens. Assessments were conducted in three time periods: before the chemotherapy, in 84 days, and in 140 days. General and biochemical blood counts were analyzed, and heart rhythm and conductivity disorders were assessed using 12-lead electrocardiography.
 Results: The risk of developing anaemia did not significantly differ between the two groups during the first examination. A trend of increased conductivity disorder rates was observed in multiple myeloma patients with concomitant coronary artery disease compared to those without heart disorders. After the fourth chemotherapy course, there was a tendency for increased heart rhythm disorder rates in multiple myeloma patients with concomitant coronary artery disease compared to the previous examination, although supraventricular rhythm disorders were more frequently observed during the third examination.
 Conclusions. Multiple myeloma onset was associated with similar rates of rhythm disorder development in patients with and without concomitant coronary artery disease, but combined rhythm disorders were observed only in patients with concomitant coronary artery disease. There has been found a tendency for increased heart rhythm disorder rates after the fourth chemotherapy course in multiple myeloma patients with concomitant coronary artery disease. Additionally, there has been a trend of increased conductivity disorder rates in multiple myeloma patients at high cardiovascular risk compared to those without concomitant heart disorders