Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer

Cardio-Oncology

Laila Hubbert¹  Yvonne Wengström²  Narsis A. Kiani³  Jonas Bergh⁴  Renske Altena⁴  Elham Hedayati⁴ 

[1] Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden;Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden;Department of Oncology and Pathology Cancer Center Karolinska, Karolinska Institutet, Stockholm, Sweden;Department of Oncology and Pathology Cancer Center Karolinska, Karolinska Institutet, Stockholm, Sweden;Medical Unit breast, endocrine tumours and sarcoma, Theme Cancer, Karolinska University Hospital Stockholm, Solna, Sweden;

关键词: Prevention;    Cancer survivor;    Evidence-based;    Cardiotoxicity;    Lifestyle;    Exercise;   

DOI  :  10.1186/s40959-021-00105-y

来源: Springer

【 摘 要 】

BackgroundCancer treatment-related morbidity relevantly compromises health status in cancer survivors, and efforts to optimise health-related outcomes in this population are vital to maximising healthy survivorship. A pre-treatment assessment – and possibly preventive management strategies – of cancer patients at increased risk for cardiovascular disease (CVD) seems a rational approach in this regard. Definitive evidence for such strategies is largely lacking, thereby impeding the formulation of firm recommendations.ResultsThe current scoping review aims to summarise and grade the evidence regarding strategies for prediction and prevention of CVD in adults in relation to oncological treatments. We conducted a scoping literature search for different strategies for primary prevention, such as medical and lifestyle interventions, as well as the use of predictive risk scores. We identified studies with moderate to good strength and up to now limited evidence to recommend primary preventive strategies in unselected patients treated with potentially cardiotoxic oncologic therapies.ConclusionEfforts to minimize the CVD burden in cancer survivors are needed to accomplish healthy survivorship. This can be done by means of robust models predictive for CVD events or application of interventions during or after oncological treatments. Up to now there is insufficient evidence to implement preventive strategies in an unselected group of patients treated with potential cardiotoxic oncological treatments. We conclude that randomised controlled trials are needed that evaluate medical and lifestyle interventions in groups at increased risk for complications, in order to be able to influence chronic illness risks, such as cardiovascular complications, for cancer survivors.

【 授权许可】

CC BY