Abstract
Patients with small cell lung cancer (SCLC) may develop heart failure after chemotherapy; therefore, it is crucial to explore the factors that affect the occurrence of heart failure. The present study retrospectively collected data from 550 patients with SCLC who received chemotherapy. Analysis of differences between groups (patients with and without heart failure, as well as patients with different severities of heart failure) was performed on demographic characteristics and cardiac biomarkers, followed by multivariate and multinomial logistic regression analyses on factors that were found to be significantly different in the intergroup analysis, to screen for factors that significantly influence heart failure. Finally, receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of combined indicators for the occurrence and severity of heart failure. Multivariate logistic regression analysis initially identified the cumulative dose of chemotherapy drugs, cardiac troponin I (cTnI), N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction (LVEF) and creatine kinase-myocardial band as independent prognostic factors of heart failure. Multinomial logistic regression analysis showed that both cTnI and LVEF had significant effects in predicting the severity of heart failure. ROC curve analysis demonstrated that a cTnI level ≥0.044 ng/ml and LVEF ≤39.083% could predict the occurrence of heart failure, whereas a cTnI level ≥0.059 ng/ml and LVEF ≤37.216% were associated with moderate-to-severe heart failure. The standardized combination indicators (cTnI and LVEF) also showed strong predictive ability (AUC >0.75). In conclusion, the present study demonstrated that cTnI, LVEF and their combination may serve as independent prognostic factors for predicting the occurrence and severity of heart failure in patients with SCLC after chemotherapy. These findings suggest that cTnI and LVEF should be routinely monitored during the early stages of chemotherapy for identifying patients at high risk for heart failure and early intervention, ultimately improving patient prognosis.