AIMS: Cardio-oncology clinics optimise the cardiovascular status of cancer patients but there is a limited description of their structure, case mix, activity and results. The purpose of this paper is to describe the activity and outcomes of a cardio-oncology service, particularly with respect to supporting optimal cancer treatment and survival. METHODS AND RESULTS: We prospectively studied patients referred to our service from February 2011 to February 2016. New York Heart Association (NYHA) class and parameters of cardiac function were measured at baseline and after optimisation by our service. Up-titration of cardiac treatment, continuation of cancer therapy and mortality were used as outcome measures. Of the 535 patients (55.8% females) referred, rates of cardiotoxicity for anthracyclines, anti-HER2 agents and tyrosine kinase inhibitors were 75.8%, 69.8% and 62.1%, respectively. Patients with left ventricular systolic dysfunction (LVSD) (n =128) were younger, had higher rates of hypertension and previous exposure to chemotherapy/radiotherapy (P < 0.001). At a median follow-up of 360 days, 93.8% of the patients with LVSD showed improvement in left ventricular ejection fraction (45% pre vs. 53% post; P < 0.001) and NYHA class (NYHA III-IV in 22% pre vs. 10% post; P = 0.01). All patients with normal left ventricular ejection fraction and biochemical or functional myocardial toxicity and 88% of patients with LVSD were deemed fit for continuation of cancer therapy after cardiovascular optimisation. CONCLUSIONS: Through the establishment of a cardio-oncology service, it is feasible to achieve high rates of cardiac optimisation and cancer treatment continuation.
AIMS: Cardio-oncology clinics optimise the cardiovascular status of cancerpatients but there is a limited description of their structure, case mix, activity and results. The purpose of this paper is to describe the activity and outcomes of a cardio-oncology service, particularly with respect to supporting optimal cancer treatment and survival. METHODS AND RESULTS: We prospectively studied patients referred to our service from February 2011 to February 2016. New York Heart Association (NYHA) class and parameters of cardiac function were measured at baseline and after optimisation by our service. Up-titration of cardiac treatment, continuation of cancer therapy and mortality were used as outcome measures. Of the 535 patients (55.8% females) referred, rates of cardiotoxicity for anthracyclines, anti-HER2 agents and tyrosine kinase inhibitors were 75.8%, 69.8% and 62.1%, respectively. Patients with left ventricular systolic dysfunction (LVSD) (n =128) were younger, had higher rates of hypertension and previous exposure to chemotherapy/radiotherapy (P < 0.001). At a median follow-up of 360 days, 93.8% of the patients with LVSD showed improvement in left ventricular ejection fraction (45% pre vs. 53% post; P < 0.001) and NYHA class (NYHA III-IV in 22% pre vs. 10% post; P = 0.01). All patients with normal left ventricular ejection fraction and biochemical or functional myocardial toxicity and 88% of patients with LVSD were deemed fit for continuation of cancer therapy after cardiovascular optimisation. CONCLUSIONS: Through the establishment of a cardio-oncology service, it is feasible to achieve high rates of cardiac optimisation and cancer treatment continuation.
Authors: Jose A Alvarez-Cardona; Jordan Ray; Joseph Carver; Vlad Zaha; Richard Cheng; Eric Yang; Joshua D Mitchell; Keith Stockerl-Goldstein; Lavanya Kondapalli; Susan Dent; Anita Arnold; Sherry Ann Brown; Monica Leja; Ana Barac; Daniel J Lenihan; Joerg Herrmann Journal: J Am Coll Cardiol Date: 2020-11-10 Impact factor: 24.094
Authors: José Luis Zamorano; Christer Gottfridsson; Riccardo Asteggiano; Dan Atar; Lina Badimon; Jeroen J Bax; Daniela Cardinale; Antonella Cardone; Elizabeth A M Feijen; Péter Ferdinandy; Teresa López-Fernández; Chris P Gale; John H Maduro; Javid Moslehi; Torbjørn Omland; Juan Carlos Plana Gomez; Jessica Scott; Thomas M Suter; Giorgio Minotti Journal: Eur J Heart Fail Date: 2020-10-02 Impact factor: 15.534
Authors: Robin L Jones; Thomas J Herzog; Shreyaskumar R Patel; Margaret von Mehren; Scott M Schuetze; Brian A Van Tine; Robert L Coleman; Roland Knoblauch; Spyros Triantos; Peter Hu; Waleed Shalaby; Tracy McGowan; Bradley J Monk; George D Demetri Journal: Cancer Med Date: 2021-05-07 Impact factor: 4.452