Katia Bravo-Jaimes1, Roselande Marcellon2, Liubou Varanitskaya3, Peter Y Kim4, Cezar Iliescu4, Susan C Gilchrist4, Lauren A Baldassarre5, Charlotte Manisty6, Arjun K Ghosh7, Avirup Guha8, Juan C Lopez-Mattei4. 1. Division of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston, Texas. 2. School of Medicine, Albany Medical College, Albany, New York, USA. 3. School of Medicine, Martin Luther University of Halle-Wittenberg, Halle, Germany. 4. Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Section of Cardiovascular Medicine, Yale School of Medicine. New Haven, Connecticut, USA. 6. Institute of Cardiovascular Sciences, University College London. 7. Cardio-Oncology Service, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom. 8. Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
Abstract
PURPOSE OF REVIEW: Cancer patients often have cardiovascular risk factors at the time of cancer diagnosis, which are known to increase the risk of cardiotoxicity. Cancer survivors have significantly higher cardiovascular risk. Current cardiovascular disease prevention guidelines are based on studies that largely excluded these patients. We reviewed recent data regarding cardiovascular disease prevention in this population. RECENT FINDINGS: Nonpharmacologic therapies aiming to reduce 'lifestyle toxicity' produced by cancer treatments have demonstrated potential to decrease the incidence of adverse outcomes. Exercise before, during and after cancer treatment not only promotes higher quality of life and cardiorespiratory fitness but also reduces adverse cardiovascular outcomes. Lipid and cardiometabolic disease management is paramount but predominantly based on data that excludes these populations of cancer patients and survivors. SUMMARY: A comprehensive approach including medical evaluation, prescriptive exercise, cardiac risk factor modification, education, counseling, pharmacologic and behavioral interventions are needed in cancer patients. These interventions constitute the core of cardio-oncology rehabilitation programs, which if implemented appropriately may help reduce cardiovascular events in this population. Knowledge gaps in these areas are starting to be addressed by ongoing clinical trials.
PURPOSE OF REVIEW: Cancerpatients often have cardiovascular risk factors at the time of cancer diagnosis, which are known to increase the risk of cardiotoxicity. Cancer survivors have significantly higher cardiovascular risk. Current cardiovascular disease prevention guidelines are based on studies that largely excluded these patients. We reviewed recent data regarding cardiovascular disease prevention in this population. RECENT FINDINGS: Nonpharmacologic therapies aiming to reduce 'lifestyle toxicity' produced by cancer treatments have demonstrated potential to decrease the incidence of adverse outcomes. Exercise before, during and after cancer treatment not only promotes higher quality of life and cardiorespiratory fitness but also reduces adverse cardiovascular outcomes. Lipid and cardiometabolic disease management is paramount but predominantly based on data that excludes these populations of cancerpatients and survivors. SUMMARY: A comprehensive approach including medical evaluation, prescriptive exercise, cardiac risk factor modification, education, counseling, pharmacologic and behavioral interventions are needed in cancerpatients. These interventions constitute the core of cardio-oncology rehabilitation programs, which if implemented appropriately may help reduce cardiovascular events in this population. Knowledge gaps in these areas are starting to be addressed by ongoing clinical trials.
Authors: Juan C Lopez-Mattei; Eric H Yang; Maros Ferencik; Lauren A Baldassarre; Susan Dent; Matthew J Budoff Journal: JACC CardioOncol Date: 2021-12-21