Cardiovascular events in cancer survivors

Howard, Emily; Steingart, Richard M.; Armstrong, Gregory T.; Lyon, Alexander R.; Armenian, Saro H.; Voso, Maria Teresa; Cicconi, Laura; Coco, Francesco Lo; Minotti, Giorgio

doi:10.1053/j.seminoncol.2019.01.007

Cited by 7 publications

(12 citation statements)

References 31 publications

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“…Early-onset chronic progressive toxicity represents the majority of cases and occurs within 1 year of therapy, whereas late onset is uncommon and occurs at a time interval of more than 1 year after chemotherapy. 1,4,10 The mechanism of action of anthracyclines in cancer involves the interruption of replicating cells, through intercalation with DNA, as well as the inhibition of topoisomerase II. The anthracycline-induced cardiotoxicity is related to the inhibition of topoisomerase IIb in myocardial cells, which induces DNA double-strand breaks, activation of apoptosis, and increase in radical oxygen species (ROS).…”

Section: Heart Failure and Arterial Hypertensionmentioning

confidence: 99%

“…Cardiovascular diseases (CVDs) may be found more frequently in cancer patients as the aging oncologic population is growing, not only as a direct consequence of cancer itself in predisposed patients (i.e., those with associated CV risk factors) but also due to the effects of anticancer treatments (i.e., chemotherapy and/or radiotherapy). [1][2][3][4] Both traditional anticancer drugs (anthracyclines) and newer treatments (i.e., immune checkpoint inhibitors and tyrosine kinase inhibitors [TKIs]) may cause CV toxicity, through various and not yet completely elucidated mechanisms. 1 CV complications of cancer treatments may occur immediately, but, more often, anticancer therapy is associated with late toxic effects, which may impact the quality of life of cancer survivors.…”

mentioning

confidence: 99%

“…This implies that prevention strategies (including lifestyle, dietary modifications, and cardioprotective medical therapy) and clinical surveillance should be applied not only before and during the course of therapy but also in the follow-up of these patients. 4,5 The growing awareness about these issues led to develop specific approaches for CV patient assessment before starting…”

mentioning

confidence: 99%

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The Growing Impact of Cardiovascular Oncology: Epidemiology and Pathophysiology

Tufano

Coppola

Galderisi

2021

Semin Thromb Hemost

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Progress in the treatment of cancer has significantly improved survival of oncologic patients in recent decades. However, anticancer therapies, particularly some new, more potent and targeted agents, are potentially cardiotoxic. As a consequence, cardiovascular complications, including heart failure, arterial hypertension, coronary artery disease, venous thromboembolism, peripheral vascular disease, arrhythmias, pericardial disease, and pulmonary hypertension, as related to cancer itself or to anticancer treatments, are increasingly observed and may adversely affect prognosis in oncologic patients. Cardiovascular oncology is an emerging field in cardiology and internal medicine, which is rapidly growing, dealing with the prevention, the early detection, and the management of cardiovascular disease, in all stages of anticancer therapy and during the survivorship period, now crucial for reducing cardiovascular morbidity and mortality in cancer patients. In this narrative review, the existing literature regarding the epidemiology of cardiovascular oncology, the mechanisms of cardiovascular complications in cancer, and the pathophysiology of cardiotoxicity related to chemotherapeutic agents, targeted therapies, immunotherapies, and radiotherapy will be analyzed and summarized.

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Section: Heart Failure and Arterial Hypertensionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Growing Impact of Cardiovascular Oncology: Epidemiology and Pathophysiology

Tufano

Coppola

Galderisi

2021

Semin Thromb Hemost

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“…Tyrosine kinase inhibitors (TKIs) are a novel class of anticancer drugs for which the sexual dimorphism has also been described. The use of these drugs is limited by their cardiotoxicity [51]. They are small molecules that occupy the ATP binding site of the tyrosine kinase receptor inhibiting the abnormal high kinase activity and uncontrolled cell growth [64].…”

Section: Targeted Therapies: Tyrosine Kinase Receptor Inhibitorsmentioning

confidence: 99%

“…These differences result from the presence of women specific forms of primary disease and sex-specific biological response. The most common forms of CRCD are secondary to breast cancer treatment, which is strongly sex-oriented, followed by hematological malignancies [ 22 , 51 ]. Women with CRCD that progressed to DCM are older, have smaller end-diastolic volume index, have higher left ventricular EF, have a lower burden of scar at CMR, have a worse NYHA class but a better long-term prognosis, and have higher rate of previous chemotherapy exposure compared with women with the diagnosis of primary DCM [ 52 – 54 ].…”

Section: Sex-related Differences In Mechanisms and Management Of Dilamentioning

confidence: 99%

Sex-Related Differences in Dilated Cardiomyopathy with a Focus on Cardiac Dysfunction in Oncology

et al. 2020

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Purpose of Review The aim of this report is to describe the main aspects of sex-related differences in non-ischemic dilated cardiomyopathies (DCM), focusing on chemotherapy-induced heart failure (HF) and investigating the possible therapeutic implications and clinical management applications in the era of personalized medicine. Recent Findings In cardio-oncology, molecular and multimodality imaging studies confirm that sex differences do exist, affecting the therapeutic cardioprotective strategies and, therefore, the long-term outcomes. Interestingly, compelling evidences suggest that sex-specific characteristics in drug toxicity might predict differences in the therapeutic response, most likely due to the tangled interplay between cancer and HF, which probably share common underlying mechanisms. Summary Cardiovascular diseases show many sex-related differences in prevalence, etiology, phenotype expression, and outcomes. Complex molecular mechanisms underlie this diverse pathological manifestations, from sex-determined differential gene expression to sex hormone interaction with their receptors in the heart. Non-ischemic DCM is an umbrella definition that incorporates several etiologies, including chemotherapy-induced cardiomyopathies. The role of sex as a risk factor for cardiotoxicity is poorly explored. However, understanding the various features of disease manifestation and outcomes is of paramount importance for a prompt and tailored evaluation.

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Heart Failure in Long-Term Survivors of Childhood or Adolescent Cancers

Camilli

Minotti

2021

Atlas of Imaging in Cardio-Oncology

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Cardiovascular events in cancer survivors

Cited by 7 publications

References 31 publications

The Growing Impact of Cardiovascular Oncology: Epidemiology and Pathophysiology

The Growing Impact of Cardiovascular Oncology: Epidemiology and Pathophysiology

Sex-Related Differences in Dilated Cardiomyopathy with a Focus on Cardiac Dysfunction in Oncology

Heart Failure in Long-Term Survivors of Childhood or Adolescent Cancers

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