CHF in Pregnancy Up for Cancer Survivors With Cardiac Toxicity

Incidence of congestive heart failure 31% among women with a history of cardiotoxicity.
Incidence of congestive heart failure 31% among women with a history of cardiotoxicity.

HealthDay News — The incidence of congestive heart failure (CHF) during pregnancy is 31% among women with a history of cardiotoxicity associated with cancer treatment, according to a study published in the October 23 issue of the Journal of the American College of Cardiology.

Shiying Liu, MD, from the University of Toronto, and colleagues retrospectively identified consecutive female cancer survivors previously exposed to potentially cardiotoxic treatments to examine the incidence of cardiac decompensation during pregnancy. Data were included for 78 women with 94 pregnancies; the women had received cancer therapy as children, adolescents, or young adults (55 received anthracyclines and 23 received non-anthracycline chemotherapy and/or radiation therapy only). 

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Fifteen of the 94 pregnancies occurred in 13 women with a prior history of cardiotoxicity, 12 of whom were treated with anthracyclines. The researchers found that primary outcomes occurred in 5 pregnancies (5.3%) in 4 women and consisted exclusively of CHF. The incidence of CHF was 31 and 0% among women with and without a history of cardiotoxicity, respectively. Compared to women without CHF, those with CHF during pregnancy were more likely to have had a history of cardiotoxicity before pregnancy (100 vs 12%).

"For women who have been exposed to cardiotoxic treatments and have had prior cardiotoxicity, there's approximately a one in three chance of developing CHF with pregnancy," a coauthor said in a statement. "These women should receive close cardiac surveillance during pregnancy."

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