Key result
Review identifies hypertension, reduced LVEF, arrhythmias, and elevated hs-cTnT as key chemotherapy cardiotoxicity indicators.
Why the study?
Chemotherapy-related cardiotoxicity is a significant complication in cancer management with increasing incidence of cardiovascular events linked to treatment, necessitating identification of clinical predictors of cardiovascular risk.
Adult cancer patients undergoing chemotherapy require comprehensive cardiovascular surveillance to monitor for cardiotoxicity indicators such as reduced ejection fraction, arrhythmias, and elevated cardiac biomarkers.
May guide cardiotoxicity surveillance in chemotherapy patients; leaves open need for prospective validation of these indicators.
All articles of this category (opens in new window) Address for correspondence Luís Carlos Lopes-Júnior (lopesjr.lc@gmail.com) Background: Chemotherapy-related cardiotoxicity is a significant complication in cancer management, potentially disrupting treatment continuity and negatively impacting survival and quality of life. Cancer and cardiovascular diseases (CVDs) share common risk factors such as sedentary behavior, obesity, smoking, and low socioeconomic status. Both are among the leading causes of global mortality. As cancer survival improves, the incidence of cardiovascular events linked to treatment—such as atrial fibrillation, heart failure, and coronary artery disease—has also increased. Evidence indicates that chemotherapeutic agents, such as anthracyclines and tyrosine kinase inhibitors, are associated with various forms of cardiotoxicity, which may arise at any stage of treatment. Objective: To map the clinical indicators that predict cardiovascular risk in adult patients undergoing chemotherapy. Methods: A scoping review (ScR) was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and guided by the Joanna Briggs Institute (JBI) methodology. Searches were performed in MEDLINE/PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, and PsycINFO, as well as clinical trial registries such as ClinicalTrials.gov, WHO ICTRP, and medRxiv. No language or publication date restrictions were applied. Two independent reviewers conducted all stages of the review process. Results: A total of 3,100 studies were identified, of which 10 met the inclusion criteria. The most frequently reported clinical cardiac indicators included: elevated blood pressure, syncope, hypotension, angina, reduced left ventricular ejection fraction, supraventricular arrhythmias, increased stress-induced ejection fraction, QTc prolongation, tachycardia, tachypnea, severe diffuse hypokinesia of the left ventricle, hs-cTnT levels >14 ng/L, and higher baseline levels of myeloperoxidase. Conclusion: The findings highlight the negative impact of chemotherapy on cardiovascular homeostasis and emphasize the need for comprehensive cardiovascular assessment throughout treatment, including post-treatment surveillance. These results also support the implementation of targeted clinical strategies for the prevention and management of cardiovascular complications in oncology patients. Publication History Article published online: 26 June 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil Bibliographical Record Naira Santos D'Agostini, Karla Anacleto de Vasconcelos, Karoline Neumann, Joel da Silva Barreto Neto, André Anderson Borges Mello, Jonathan Grassi, Caroline Naimeg da Mata, Luiz Claudio Barreto Silva Neto, Etreo Junior Carneiro da Silva Minarini, Juliano Coimbra dos Santos, Anna Clara Silva Victor de Souza, Sara Isabel Pimentel de Carvalho Schuab, Karolini Zuqui Nunes, Luís Carlos Lopes-Júnior. Clinical Predictors of Cardiovascular Risk in Adult Cancer Patients Undergoing Chemotherapy: A Scoping Review. Brazilian Journal of Oncology 2026; 22. DOI: 10.1055/s-0046-1825350
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D’Agostini et al. (2026) conducted a review in Cancer (n=10). Chemotherapy was evaluated on Clinical indicators that predict cardiovascular risk. A scoping review of 10 studies identified key clinical cardiac indicators of chemotherapy-related risk, including elevated blood pressure, reduced LVEF, arrhythmias, and hs-cTnT >14 ng/L.
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