Abstract Abstract Cardiovascular (CV) disease in patients with cancer remains a common challenge for both patients and clinicians, and its presence increases the risk of cardiotoxicity, with an impact on prognosis. However, there is limited data on CVD prevalence in these patients (pts). Objectives To assess the characteristics of gastrointestinal cancer pts with specific oncological treatment and the prevalence of CV risk factors/diseases and their contemporary management. Methods We prospectively included all consecutive gastrointestinal cancer pts referred for oncological treatment during one week in November 2024 to our hospital's Gastrointestinal Oncology Unit. Clinical, biological (including cardiac biomarkers), electrocardiographic, and basic transthoracic echocardiographic data were collected in all pts. Results We prospectively enrolled 100 consecutive pts within one week (mean age 63±9 years, 8% of participants ≥ 75 years of age; 61% males). The most common cancer type was colorectal (39%), followed by liver (14%) and pancreatic (12%) cancers. 62% of patients had metastatic cancer. Chemotherapy with fluoropyrimidines was administered in most cases (86% of pts). Immunotherapy with immune checkpoint inhibitors (Atezolizumab) was noticed in 15% of pts, and therapy with vascular endothelial growth factor inhibitors (Bevacizumab, Ramucirumab) in 28% cases. Hypertension (62%), hypercholesterolemia (40%) and type 2 diabetes (26%) were the most prevalent CV risk factors. Two patients had a known history of non-obstructive coronary artery disease. No patient had peripheral arterial disease. Valvular heart disease was present in 11% of patients, with aortic stenosis being the most frequent valve disease (severe AS in 1 patient). Five patients had atrial fibrillation (AF) history, including 2 pts with permanent AF and 3 with a history of paroxistic AF. There was no new discovery of AF in this screening program. All pts with AF had therapy with a novel oral anticoagulant (apixaban in all cases) based on a CHA2DS2VA score above 2 in all. Four pts had a HAS-BLED score of ≥3. Previous thromboembolic and hemorrhagic events occurred in 13% and 9% (all minor) of all subjects, respectively. Heart failure (HF) was present in 35% of pts: 32 pts with preserved left ventricular (LV) ejection fraction (EF) and 3 pts with reduced LV EF. Pts with HF had higher blood pressure values (p=0.001), larger both left and right atrial dimensions (p0.001 and p=0.008, respectively), as well as a higher LV mass index (p=0.001). NTproBNP and TnI hs values were also higher in HF pts (p0.001 and p=0.006, respectively). Conclusions Our study provides extensive information on a cohort of pts with gastrointestinal cancer in a real-life setting. It highlights the high prevalence of associated CV risk factors and CV disease, mainly heart failure, potentially leading to challenges of cancer therapies, underlining again the need to integrate early CV assessment in managing these pts.
Mateescu et al. (Fri,) studied this question.