Efficacy of Neurohormonal Therapies in Preventing Cardiotoxicity in Patients With Cancer Undergoing Chemotherapy

Vaduganathan, Muthiah; Hirji, Sameer; Qamar, Arman; Bajaj, Navkaranbir; Gupta, Ankur; Zaha, Vlad G.; Chandra, Alvin; Haykowsky, Mark J.; Ky, Bonnie; Moslehi, Javid; Nohria, Anju; Butler, Javed; Pandey, Ambarish

doi:10.1016/j.jaccao.2019.08.006

Cited by 100 publications

(100 citation statements)

References 41 publications

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“…Overall, a recent meta-analysis of randomized clinical trials of adult patients that underwent chemotherapy and cardiovascular therapies vs. placebo with follow-up (17 trials, 1,984 patients) showed higher (although with small changes) LVEF values at follow-up in cancer patients receiving neurohormonal therapies (99).…”

Section: The Use Of Cardiovascular Agentsmentioning

confidence: 99%

Cardiotoxicity of Anthracyclines

Cardinale

Fabiani

Cipolla

2020

Front. Cardiovasc. Med.

279

214

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Cardiotoxicity is a feared side effect that may limit the clinical use of anthracyclines. It may indeed affect the quality of life and survival of patients with cancer, regardless of oncological prognosis. This paper provides an overview of anthracycline-induced cardiotoxicity in terms of definition, classification, incidence, risk factors, possible mechanisms, diagnosis, and treatment. We also report effective strategies for preventing cardiotoxicity. In addition, we discuss limiting current approaches, the need for a new classification, and early cardiotoxicity detection and treatment. Probably, anthracycline-induced cardiotoxicity is a continuous phenomenon that starts from myocardial cell injury; it is followed by left ventricular ejection fraction (LVEF) and, if not diagnosed and cured early, progressively leads to symptomatic heart failure. Anthracycline-induced cardiotoxicity can be detected at a preclinical phase. The role of biomarkers, in particular troponins, in identifying subclinical cardiotoxicity and its therapy with angiotensin-converting enzyme inhibitors (mainly enalapril) to prevent LVEF reduction is a recognized and effective strategy. If cardiac dysfunction has already occurred, partial or complete LVEF recovery may still be obtained in case of early detection of cardiotoxicity and prompt heart failure treatment.

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Section: The Use Of Cardiovascular Agentsmentioning

confidence: 99%

Cardiotoxicity of Anthracyclines

Cardinale

Fabiani

Cipolla

2020

Front. Cardiovasc. Med.

279

214

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“…Lifetime appropriate screening and surveillance would also be key (3,4,55). Meta-analyses and systematic reviews have suggested cardioprotective effects of beta blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, statins, dexrazoxane, and continuous infusion of a limited dose of liposomal doxorubicin, particularly for individuals with breast cancer receiving chemotherapy with anthracyclines, trastuzumab, or both (56)(57)(58)(59). A single-center study determined deep inspiration breath hold as an effective method to reduce CV toxicity in patients with breast cancer (60).…”

Section: Pharmacologic Therapies and Oncologic Treatment Maneuvers Inmentioning

confidence: 99%

Preventive Cardio-Oncology: The Time Has Come

Brown

2020

Front. Cardiovasc. Med.

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“…Drugs with an effect on neurohumoral blockade as beta-blockers (BB) angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin-II receptor blockers (ARBs) 159 and mineralocorticoid receptor antagonists (MRA), ACEI = angiotensin converting enzyme inhibitors, ARBs = angiotensin-II receptor blockers, BB = beta blockers, RCT = randomized controlled clinical trials, m = month, y = year, QT = chemotherapy, AC= anthracycline, TZ = trastuzumab, LVEF = left ventricular ejection fraction, MACE= cardiovascular outcomes, GLS = overall longitudinal strain, HF = heart failure, BNP = brain natriuretic peptide. Modified from: Curigliano G et al 88 www.medigraphic.org.mx are those with the most studies 88 and report reduction in rates of left ventricular dysfunction compared with placebo (3.96%; 95% CI, 2.90-5.20) 12 (Table 6).…”

Section: Addition Of Cardioprotective Drugsmentioning

confidence: 99%

Abordaje de la enfermedad cardiovascular en mujeres con cáncer de mama. Posición de la Asociación Nacional de Cardiólogos de México (ANCAM)

Figueiras-Graillet¹,

García-Jiménez²,

Rosas-Munive³

et al. 2020

Cardiovasc Metab Sci

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La enfermedad cardiovascular es la primera causa de muerte en la mujer que sobrevive al cáncer de mama. La magnitud de los efectos cardiotóxicos depende no sólo del tratamiento antineoplásico, sino de la susceptibilidad individual, que está determinada por la enfermedad cardiovascular preexistente y los factores de riesgo concurrentes, así como de las intervenciones en la prevención, identificación y tratamiento oportuno de la cardiotoxicidad. La Asociación Nacional de Cardiólogos de México, inmersa en esta realidad, comparte en el presente documento un abordaje que explica la interacción de las dos entidades desde la perspectiva de la mujer de alto riesgo y resume las estrategias de detección y cardioprotección actuales.

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Efficacy of Neurohormonal Therapies in Preventing Cardiotoxicity in Patients With Cancer Undergoing Chemotherapy

Cited by 100 publications

References 41 publications

Cardiotoxicity of Anthracyclines

Cardiotoxicity of Anthracyclines

Preventive Cardio-Oncology: The Time Has Come

Abordaje de la enfermedad cardiovascular en mujeres con cáncer de mama. Posición de la Asociación Nacional de Cardiólogos de México (ANCAM)

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