Activity and outcomes of a cardio‐oncology service in the United Kingdom—a five‐year experience

Pareek, Nilesh; Cevallos, Joaquim; Moliner, Pedro; Shah, Mit; Tan, Li; Chambers, Vicki; Baksi, A. John; Khattar, Rajdeep; Sharma, Rakesh; Rosen, Stuart D.; Lyon, Alexander R.

doi:10.1002/ejhf.1292

Cited by 113 publications

(120 citation statements)

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“…It is most commonly defined as meeting three out of five phenotypic criteria: low physical activity, unintentional weight loss, slow walking speed, weak grip strength, and/or exhaustion. 211 Development of cardiac dysfunction after anthracycline therapy is associated with similar outcomes as other nonischaemic cardiomyopathies. 206 Adiposity is associated with increased ventricular-arterial stiffness among the elderly and suggest a potential role in the development of HF.…”

Section: Comorbiditiesmentioning

confidence: 99%

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Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Section: Comorbiditiesmentioning

confidence: 99%

“…206 Adiposity is associated with increased ventricular-arterial stiffness among the elderly and suggest a potential role in the development of HF. 211 Prospective registries are established. 208 Cancer therapies are associated with side effects including up to nine categories of cardiovascular complications.…”

Section: Comorbiditiesmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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“…23 The third phase of prevention consists of long-term surveillance of cancer survivors. 84 Recent data from Pareek et al 84 demonstrated the effectiveness of these services. CV disease can develop many years after diagnosis and treatment of cancer.…”

Section: Diagnosis and Preventionmentioning

confidence: 99%

Recent advances in cardio‐oncology: a report from the ‘Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019’

et al. 2019

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While anti-cancer therapies, including chemotherapy, immunotherapy, radiotherapy, and targeted therapy, are constantly advancing, cardiovascular toxicity has become a major challenge for cardiologists and oncologists. This has led to an increasing demand of cardio-oncology units in Europe and a growing interest of clinicians and researchers. The Heart Failure 2019 meeting of the Heart Failure Association of the European Society of Cardiology in Athens has therefore created a scientific programme that included four dedicated sessions on the topic along with several additional lectures. The major points that were discussed at the congress included the implementation and delivery of a cardio-oncology service, the collaboration among cardio-oncology experts, and the risk stratification, prevention, and early recognition of cardiotoxicity. Furthermore, sessions addressed the numerous different anti-cancer therapies associated with cardiotoxic effects and provided guidance on how to treat cancer patients who develop cardiovascular disease before, during, and after treatment.

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“…Treating heart failure and cancer, two malignant diseases, at the same time is challenging for both oncologists and cardiologists . Many centres of excellence have established cardio‐oncology services to evaluate the risk of cardiotoxicity, monitor the effects of therapy on cardiac function, ensure that curative treatment for cancer is not inappropriately withheld and manage patients who develop cardiac dysfunction and heart failure whilst being treated for cancer . We must hope that all patients with heart failure have access to similar resources for their care when needed and not just those with two malignant diseases rather than just one.…”

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confidence: 99%

What do patients with heart failure die from? A single assassin or a conspiracy?

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Hülsmann

Cleland

2019

European J of Heart Fail

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Activity and outcomes of a cardio‐oncology service in the United Kingdom—a five‐year experience

Abstract: Through the establishment of a cardio-oncology service, it is feasible to achieve high rates of cardiac optimisation and cancer treatment continuation.

Cited by 113 publications

References 25 publications

Highlights in heart failure

Highlights in heart failure

Recent advances in cardio‐oncology: a report from the ‘Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019’

What do patients with heart failure die from? A single assassin or a conspiracy?

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