Practical Approaches to Build and Sustain a Cardio-Oncology Clinic

Chasouraki, Angeliki; Kourek, Christos; Sianis, Alexandros; Loritis, Konstantinos; Kostakou, Peggy; Tsougos, Elias; Paraskevaidis, Ioannis; Ntalianis, Argyrios; Briasoulis, Αlexandros

doi:10.3390/jcdd9050158

Cited by 2 publications

(2 citation statements)

References 34 publications

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“…At the same time, numerous studies have demonstrated various side effects caused by chemotherapy and radiation therapy, among which cardiotoxicity has the most significant prognostic value [2,3]. Clinical manifestations of antitumor therapies' cardiotoxicity vary widely from asymptomatic subclinical changes recorded only by special imaging techniques such as global longitudinal strain measurement (GLS) and 3D-Echocardiography (EchoCG) to severe clinical symptoms evidencing heart failure and requiring emergency hospital admission [4]. Cardiotoxicity, or, according to the current definition, cancer treatment-related cardiovascular disease (CTRCD), can develop both during antitumor therapy and in the first year or even years after chemotherapy completion [5].…”

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confidence: 99%

Stratifying breast cancer patients by baseline risk of cardiotoxic complications linked to chemotherapy

et al. 2023

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A majority of modern antitumor pharmaceuticals are accompanied by cardiotoxicity. The study aims to present practical approaches to stratifying the baseline risk of antitumor therapies' cardiotoxicity in patients newly diagnosed with breast cancer started on anthracyclines and/or trastuzumab. Material and methods: Stratifying the risks of antitumor therapy was carried out according to the European Society of Cardiology recommendations. A therapist examined all patients for existing cardiovascular diseases and risk factors detection. The blood levels of glucose, cholesterol, creatinine, cardiac troponin I, and brain natriuretic peptide were determined. Electrocardiography and echocardiography with an assessment of the myocardium global longitudinal strain were performed. Results: In total, 128 breast cancer patients with a mean age of 54.3±11.0 years were included in the study. Of them, 84.4% had tumor stages I and II, and 21.1% were HER2-positive. Chronic heart failure and ischemic heart disease were detected in 2.3%.  Among the risk factors, the most common were arterial hypertension (51.6%), obesity (29.7%), age 65-70 years (18%), significant smoking history (15.6%), and diabetes mellitus (11.7%). Elevated cardiac troponin I and brain natriuretic peptide baseline levels were present in 5.5% and 7.0% of patients, respectively. To a high-risk group for cardiotoxic complications, 7.8% were allocated, 35.7% were assigned to the moderate-risk group, and 54.7% had low risk. High/very high and moderate-risk patients (43.5%) were referred to a cardiologist. Cardioprotective treatment was started immediately in high/very high-risk patients. Conclusion: All revealed differences between the cardiovascular risk groups were related to age, cardiovascular system condition, and the severity of comorbid pathologies. The baseline stratification of patients into risk groups is a crucial step in preventing the cardiotoxicity of anticancer therapy. Comprehensive assessing the patient's condition before and during chemotherapy allows for avoiding the development of fatal cardiovascular complications in at-risk patients.

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Section: Introductionmentioning

confidence: 99%

Stratifying breast cancer patients by baseline risk of cardiotoxic complications linked to chemotherapy

et al. 2023

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“…Therefore, there is an unmet need for development and implementation of cardio-oncology programs, in order to surveil and manage cardiovascular complications before, during, and years after treatment in cancer patients. The smooth operation of such programs requires the close collaboration of health care professionals from different specialties such as oncology, cardiology, and hematology [ 6 , 7 ]. In this regard, Čiburienė et al reported the 6-year experience of the first cardio-oncology service in Vilnius, Lithuania [ 8 ].…”

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confidence: 99%