OBJECTIVE: To probe into the related risk factors of cardiotoxicity in patients with breast cancer after sequential trastuzumab therapy with anthracyclines. METHODS: Totally 169 patients with breast cancer undergoing sequential trastuzumab therapy with anthracyclines in this hospital from Apr. 2017 to Jan. 2020 were extracted to be divided into the cardiotoxicity group and the non-cardiotoxicity group according to the incidence of cardiotoxicity. The age

body mass index

tumor stage

history of hypertension

history of diabetes

history of hyperlipidemia

combined radiotherapy

categories of anthracyclines and other factors of two groups of patients were recorded and analyzed. Risk factors of cardiotoxicity in patients with breast cancer after sequential trastuzumab therapy with anthracyclines were analyzed by logistic regression. RESULTS: Among 169 patients with breast cancer after sequential trastuzumab therapy with anthracyclines

57 patients developed cardiotoxicity

with the incidence of 33.73%. There were statistically significant differences between the cardiotoxicity group and the non-cardiotoxicity group in the history of hyperlipidemia

combined radiotherapy and categories of anthracyclines（P<0.05）. Further analysis showed that patients with hyperlipidemia had an increased risk of cardiotoxicity compared with those without hyperlipidemia（OR=5.068

95%CI=2.209-11.628）. Patients treated with left thoracic radiotherapy had an increased risk of cardiotoxicity compared with those without combined radiotherapy（OR=3.734

95%CI=1.448-9.628）. Compared with patients received epirubicin

patients received pirarubicin had a lower risk of cardiotoxicity（OR=0.407

95%CI=0.182-0.911）. CONCLUSIONS: The incidence of cardiotoxicity in patients with breast cancer after sequential trastuzumab therapy with anthracyclines is higher. Treatment with epirubicin

history of hyperlipidemia and history of left thoracic radiotherapy are independent risk factors for cardiotoxicity in patients with breast cancer after sequential trastuzumab therapy with anthracyclines.