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Cardiovascular risk in long-term survivors of testicular cancer

✍ Scribed by David J. Vaughn; Steven C. Palmer; Joseph R. Carver; Linda A. Jacobs; Emile R. Mohler

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
95 KB
Volume
112
Category
Article
ISSN
0008-543X

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✦ Synopsis

Abstract

BACKGROUND

Long‐term survivors of testicular cancer (TC) who received cisplatin‐based chemotherapy have an increased risk of cardiovascular disease. A cross‐sectional study was performed to objectively assess cardiovascular risk, subclinical atherosclerosis, and endothelial function in long‐term survivors of TC.

METHODS

Long‐term survivors of TC underwent evaluation including determination of body mass index (BMI), Framingham relative risk (RR), brachial artery flow‐mediated dilatation (FMD), carotid artery intima‐media thickness (IMT), soluble intercellular adhesion molecule‐1 (sICAM‐1), high sensitivity C‐reactive protein (hs‐CRP), and flow cytometric analysis of peripheral blood for levels of endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs). TC survivors who received chemotherapy were compared with a chemotherapy naive cohort.

RESULTS

Twenty‐four patients received cisplatin‐based chemotherapy (CBCT) and 15 were chemotherapy‐naive (CN). The CBCT cohort demonstrated more impairment of brachial artery FMD than the CN group (5.6% vs 8.8%; P = .05). The mean sICAM was also found to be higher in the CBCT cohort compared with the CN group (P = .04). No significant differences between the groups were noted with regard to BMI, Framingham RR, carotid IMT, or hs‐CRP. In a subset of patients, TC survivors who received chemotherapy had a significantly increased level of CECs compared with CN patients (P = .04). No significant difference in EPC levels was detected.

CONCLUSIONS

Long‐term survivors of TC who received chemotherapy demonstrate objective evidence of endothelial injury and dysfunction, a potential mechanism for increased cardiovascular risk. Cancer 2008. © 2008 American Cancer Society.

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