Cardiovascular risk of BRCA1/2 mutation carriers: A review

Westerop, Liselore L.M. van; Jong, M.A.D.W. de; Hoogerbrugge, Nicoline; Hullu, Joanne A. de; Maas, Angela H.E.M.

doi:10.1016/j.maturitas.2016.06.012

Cited by 26 publications

(11 citation statements)

References 64 publications

(66 reference statements)

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“…Interestingly, these BRCA genes are also involved in preservation of cardiac function, and abnormalities may affect susceptibility to cardiac damage. It has been observed that the presence of either of these gene abnormalities is associated with a higher risk of heart failure in patients receiving anthracycline‐based therapies, irrespective of duration and dosing of anthracycline exposure …”

Section: Shared Risk Factors For Breast Cancer and Cardiovascular Dismentioning

confidence: 99%

“…It has been observed that the presence of either of these gene abnormalities is associated with a higher risk of heart failure in patients receiving anthracycline-based therapies, irrespective of duration and dosing of anthracycline exposure. 33,34 Breast cancer survivorship has been increasing and comprises the largest group of cancer survivors in the United States. 35 Despite the increased risk of cardiovascular disease in breast cancer survivors, there are no specific guidelines for the assessment and prevention of cardiovascular risk in these patients.…”

Section: Shared Risk Factors For Breast Cancer and Cardiovascular Dmentioning

confidence: 99%

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The connection between the breast and heart in a woman: Breast cancer and cardiovascular disease

Gulati

Mulvagh

2018

Clinical Cardiology

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Cardiovascular disease remains the leading cause of death in women in the United States and is a major public health issue for all women, but it is of increasing concern to breast cancer survivors. Advancements in early detection and breast cancer therapy have resulted in over 90% of women surviving 5 years past their diagnosis of breast cancer. Nonetheless, with increased survivorship from breast cancer, there has been an increase in cardiovascular disease in these women. The consequences of the treatments for breast cancer may increase the risk for cardiovascular disease. Additionally, there is an overlap of risk factors common to both breast cancer and cardiovascular disease. The increased risk of cardiovascular disease in women who survive breast cancer must be recognized, with a focus on the prevention and early detection of cardiovascular disease.

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Section: Shared Risk Factors For Breast Cancer and Cardiovascular Dismentioning

confidence: 99%

Section: Shared Risk Factors For Breast Cancer and Cardiovascular Dmentioning

confidence: 99%

The connection between the breast and heart in a woman: Breast cancer and cardiovascular disease

Gulati

Mulvagh

2018

Clinical Cardiology

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“…Follow-up studies reported an association between single nucleotide polymorphisms in BRCA1 -associated protein and myocardial infarction risk in a large Japanese patient cohort with replication in additional Japanese and Taiwanese patient cohorts [ 11 ]. Even in women who do not receive anthracycline-based chemotherapy, BRCA protein deficiency can increase their susceptibility to any form of oxidative stress, whether it is from other types of cancer treatments, early surgical menopause, subclinical ischemia, or endothelial dysfunction from hypertension, hyperlipidemia, diabetes, or insulin resistance (which is known to be increased in the setting of BRCA protein deficiency) [ 12 , 13 , 14 ]. These mechanisms could play a role in the inherently higher risk for heart failure reported in those patients exposed to anthracyclines and those who were chemotherapy naïve.…”

Section: Discussionmentioning

confidence: 99%

An Exploratory Study to Determine Whether BRCA1 and BRCA2 Mutation Carriers Have Higher Risk of Cardiac Toxicity

Sajjad

Fradley

Sun

et al. 2017

Genes

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Anthracycline-based cardiotoxicity is concerning for women with breast cancer and portends a dose-dependent risk of developing left ventricular dysfunction. Overall, the prevalence of heart failure (HF) is ≈2% of the total US population; however, BRCA-deficient mice have shown increased HF. We evaluated for the inherent risk of HF in women with BRCA mutations to determine whether treatment with anthracycline-based therapy increased this risk. We obtained results on BRCA mutation carriers regarding cancer treatment and HF, identified through the BRCA patient advocacy organization Facing Our Risk for Cancer Empowered (FORCE) and the Moffitt-based Inherited Cancer Registry. In our patient group (232 BRCA1 and 159 BRCA2 patients; 10 with both mutations), 7.7% reported HF, with similar proportions in BRCA1 versus BRCA2 carriers (7.4% and 8.2%, respectively). These proportions are significantly higher than published rates (p < 0.001). There was no statistically significant difference in HF rates comparing anthracycline-treated versus anthracycline-naïve patients however (7.1% vs. 8.3%; p = 0.67). In addition, 9.1% of BRCA1 carriers and 8.2% of BRCA2 carriers reported arrhythmias. BRCA mutation carriers showed increased risk of cardiotoxicity versus the general population and an overall increased risk of cardiotoxicity from anthracycline-based therapy. Our study supports data that BRCA carriers have increased non-cancer mortality from cardiotoxicity. A prospective trial to determine HF and conduction abnormalities in this population is warranted.

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“…These results suggest that the carriers of the mutations are prone to have coagulation-related problems independently of malignancies. Further, low levels of insulin-like growth factor 1 (IGF-1) were detected in individuals carrying BRCA1/2 mutations, while high levels of IGF-1 were detected in BRCA1/2 mutation carriers with breast cancer; abnormal concentrations of IGF-1 have been associated with higher risks to develop insulin resistance, which contributes to the pathophysiology of many CVDs [ 100 , 102 ].…”

Section: Cardio-oncology Syndrome Type V (Cos 5): Systemic and Genetic Conditionsmentioning

confidence: 99%

A new classification of cardio-oncology syndromes

et al. 2021

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Increasing evidence suggests a multifaceted relationship exists between cancer and cardiovascular disease (CVD). Here, we introduce a 5-tier classification system to categorize cardio-oncology syndromes (COS) that represent the aspects of the relationship between cancer and CVD. COS Type I is characterized by mechanisms whereby the abrupt onset or progression of cancer can lead to cardiovascular dysfunction. COS Type II includes the mechanisms by which cancer therapies can result in acute or chronic CVD. COS Type III is characterized by the pro-oncogenic environment created by the release of cardiokines and high oxidative stress in patients with cardiovascular dysfunction. COS Type IV is comprised of CVD therapies and diagnostic procedures which have been associated with promoting or unmasking cancer. COS Type V is characterized by factors causing systemic and genetic predisposition to both CVD and cancer. The development of this framework may allow for an increased facilitation of cancer care while optimizing cardiovascular health through focused treatment targeting the COS type.

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Cardiovascular risk of BRCA1/2 mutation carriers: A review

Cited by 26 publications

References 64 publications

The connection between the breast and heart in a woman: Breast cancer and cardiovascular disease

The connection between the breast and heart in a woman: Breast cancer and cardiovascular disease

An Exploratory Study to Determine Whether BRCA1 and BRCA2 Mutation Carriers Have Higher Risk of Cardiac Toxicity

A new classification of cardio-oncology syndromes

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