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Radiation therapy could increase the risk of heart disease in young women

According to research published in JACC: CardioOncology, women with left‐sided breast cancer undergoing radiation therapy between 1985 and 2008 had over twice the risk of subsequent coronary artery disease compared with women with right‐sided breast cancer with a median of 14 years of follow‐up. Researchers studied participants in the Women’s Environmental Cancer and Radiation Epidemiology Study to evaluate the risk of coronary artery disease in breast cancer survivors. After excluding women who did not receive radiation therapy or who had a pre‐existing cardiovascular disease diagnosis, 972 women were eligible for analysis. All the participants were diagnosed with breast cancer between 1985 and 2008, were under 55 years of age, and had completed a cardiovascular health questionnaire. Clinical and lifestyle factors were distributed equally among both groups of women. Previous studies in older populations have shown left‐sided radiation therapy is associated with increased risk of developing heart disease, although the level of risk varied between studies. In the present study, although participants had equal event‐free survival of coronary artery disease for 5 years, regardless of breast cancer laterality, event‐free survival was lower among women treated with left‐sided radiation therapy at each subsequent 5‐year mark. In addition, 91% of coronary artery disease diagnoses occurred more than 5 years after radiation therapy, demonstrating the need for long term follow‐up in younger breast cancer survivors, according to the researchers. Overall, the 27.5‐year cumulative incidence of coronary artery disease for women who received left‐sided radiation therapy was 10.5% compared with 5.8% for women who underwent right‐sided radiation therapy. For women diagnosed between ages 25 and 39 years, those who received left‐sided radiation therapy had a 5.9% incidence of coronary artery disease, while those receiving right‐sided radiation therapy reported no coronary artery disease. Women who were diagnosed between ages 40 and 54 years experienced an 18.7% incidence of coronary artery disease after undergoing left‐sided radiation therapy, and 6.8% after undergoing right‐sided radiation therapy.

https://www.sciencedirect.com/science/article/pii/S2666087321001629?via%3Dihub

Common antibiotic reduces low birth weight and prematurity

A common antibiotic has been found to reduce low birth weight and premature births, if taken during pregnancy, in countries where malaria is endemic, according to a meta‐analysis, led by the University of Melbourne and the Murdoch Children’s Research Institute and published in EClinicalMedicine. The analysis found that azithromycin reduced low birth weight and prematurity in Africa and Asia but did not reduce infant deaths, infections or hospital admissions. The researchers reviewed 14 studies undertaken in African and Asian countries, involving 17 594 participants. Azithromycin is an inexpensive antibiotic widely used to treat chest and ear infections. In pregnancy, it has been specifically used to treat sexually transmitted infections and, alongside other antimalarial drugs, to prevent adverse consequences of malaria on maternal and fetal outcomes and caesarean wound infections. The authors wrote that it was unclear whether azithromycin would improve perinatal and neonatal outcomes in non‐malaria endemic settings, and the potential effect on stillbirth rates needed further investigation. Globally, infections cause about 21% of 2.4 million neonatal deaths each year and 52% of all deaths under 5 years, with a disproportionate amount occurring in low and middle income countries. Infections are also common in mothers, with about 5 million cases of pregnancy‐related infections occurring each year, resulting in 75 000 maternal deaths.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00403-X/fulltext