Cardiac and arterial complications

Rovó, Alicia; Thewis, André

doi:10.1002/9781119612780.ch25

Cited by 1 publication

(2 citation statements)

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“…[78][79][80] HF, premature coronary artery disease, valvular heart disease, and arrhythmias occur frequently and are associated with increased mortality in long-term survivors. [79][80][81] HCT survivors are at increased risk for diabetes and metabolic syndrome, and these complications also likely potentiate CVD. 13,69,78,82 Among long-term survivors, arterial disease presents more frequently as coronary or cerebrovascular disease, and isolated peripheral vascular disease is much less common.…”

Section: Hematopoietic Cell Transplant Backgroundmentioning

confidence: 99%

“…13,69,78,82 Among long-term survivors, arterial disease presents more frequently as coronary or cerebrovascular disease, and isolated peripheral vascular disease is much less common. 81 Venous thromboembolism (VTE), in contrast, is common in HCT survivors, particularly in those that develop chronic graft-versus-host disease (GVHD) and those with plasma cell diseases (who may continue to receive thrombogenic anticancer therapies) and is associated with adverse outcomes. 75,83,84 While several sex-based differences in CVD have been described in the general population, the impact of sex in transplant and subsequent CVD is not as well known.…”

Section: Introductionmentioning

confidence: 99%

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Sex-Specific Cardiovascular Risks of Cancer and Its Therapies

Wilcox

Rotz

Mullen

et al. 2022

Circulation Research

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In both cardiovascular disease and cancer, there are established sex-based differences in prevalence and outcomes. Males and females may also differ in terms of risk of cardiotoxicity following cancer therapy, including heart failure, cardiomyopathy, atherosclerosis, thromboembolism, arrhythmias, and myocarditis. Here, we describe sex-based differences in the epidemiology and pathophysiology of cardiotoxicity associated with anthracyclines, hematopoietic stem cell transplant (HCT), hormone therapy and immune therapy. Relative to males, the risk of anthracycline-induced cardiotoxicity is higher in prepubertal females, lower in premenopausal females, and similar in postmenopausal females. For autologous hematopoietic cell transplant, several studies suggest an increased risk of late heart failure in female lymphoma patients, but sex-based differences have not been shown for allogeneic hematopoietic cell transplant. Hormone therapies including GnRH (gonadotropin-releasing hormone) modulators, androgen receptor antagonists, selective estrogen receptor modulators, and aromatase inhibitors are associated with cardiotoxicity, including arrhythmia and venous thromboembolism. However, sex-based differences have not yet been elucidated. Evaluation of sex differences in cardiotoxicity related to immune therapy is limited, in part, due to low participation of females in relevant clinical trials. However, some studies suggest that females are at increased risk of immune checkpoint inhibitor myocarditis, although this has not been consistently demonstrated. For each of the aforementioned cancer therapies, we consider sex-based differences according to cardiotoxicity management. We identify knowledge gaps to guide future mechanistic and prospective clinical studies. Furthering our understanding of sex-based differences in cancer therapy cardiotoxicity can advance the development of targeted preventive and therapeutic cardioprotective strategies.

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