Key result
Cancer therapies, including chemotherapy and radiotherapy, are associated with significant cardiovascular complications, highlighting the need for specific cardio-oncology guidelines.
Cancer therapies, including traditional chemotherapy and angiogenesis inhibitors, carry significant risks of diverse cardiovascular complications requiring clinical awareness.
Urges closer cardiac monitoring during cancer therapy; leaves open prospective trials to establish guidelines.
A fundamental concept of treatment is to do no harm. However, with cancer treatment this is not always possible. is associated with cardiovascular (CV) complications.1,2 This risk is even greater in the elderly patients and patients with established CV disease. More specifically, tachyarrhythmias (eg, cisplatin), bradyarrythmias (eg, paclitaxel), or QT prolongation (eg, dasatinib) have been reported. Furthermore, myocardial necrosis, coronary vaso-occlusion or vasospasm, pericardial disease (eg, cytarabine), endocardial fibrosis (eg, busulfan), and heart failure can occur. Hypotension (eg, fludarabine) or hypertension (eg, vinca alkaloids) has also been reported.1,2 Cardiotoxicity, endothelial injury, and Takotsubo syndrome have been reported in patients treated with 5-fluorouracil (5-FU).3⇓–5 Cardiotoxicity to 5-FU was reported 35 years ago.3⇓–5 Cardiotoxicity of chemotherapy has been reported in patients ranging from children through adults (eg, with anthracyclines or cisplatin).6 Adriamycin-induced myocyte damage has been attributed to the production of toxic oxygen free radicals.7 This can cause lipid peroxidation of membranes resulting in vacuolation, irreversible damage, and myocyte replacement by fibrous tissue.7 use of angiogenesis inhibitors in cancer therapy is expanding as are the associated adverse CV effects (eg, hypertension, thromboembolism, left ventricular dysfunction, and QTc prolongation).2,8 Vascular endothelial growth factor (VEGF) plays a role in maintaining vascular homeostasis via the production of the vasodilator nitric oxide (NO) and decreased vascular resistance through the generation of new blood vessels.2,8 Therefore, it is not surprising that inhibition of VEGF signaling (eg, … [Full Text of this Article]
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Vasiliadis et al. (2013) conducted an editorial in Cancer and Cardiotoxicity. Cancer therapy (chemotherapy and radiotherapy) was evaluated. Cancer therapies, including chemotherapy and radiotherapy, are associated with significant cardiovascular complications, highlighting the need for specific cardio-oncology guidelines.
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