Top

Clinical Research in Cardiology

Published in:

Open Access 01-04-2018 | Review

Cardio-oncology: conflicting priorities of anticancer treatment and cardiovascular outcome

Authors: Lisa M. Tilemann, Markus B. Heckmann, Hugo A. Katus, Lorenz H. Lehmann, Oliver J. Müller

Published in: Clinical Research in Cardiology | Issue 4/2018

Abstract

Background

This article about the emerging field of cardio-oncology highlights typical side effects of oncological therapies in the cardiovascular system, cardiovascular complications of malignancies itself, and potential preventive or therapeutic modalities.

Methods

We performed a selective literature search in PubMed until September 2016.

Results

Cardiovascular events in cancer patients can be frequently attributed to oncological therapies or to the underlying malignancy itself. Furthermore, many patients with cancer have pre-existing cardiovascular diseases that can be aggravated by the malignancy or its therapy. Cardiovascular abnormalities in oncological patients comprise a broad spectrum from alterations in electrophysiological, laboratory or imaging tests to the occurrence of thromboembolic, ischemic or rhythmological events and the impairment of left ventricular function or manifest heart failure.

Discussion

A close interdisciplinary collaboration between oncologists and cardiologists/angiologists as well as an increased awareness of potential cardiovascular complications could improve clinical care of cancer patients and provides a basis for an improved understanding of underlying mechanisms of cardiovascular morbidity.

Schlitt A, Jordan K, Vordermark D, Schwamborn J, Langer T, Thomssen C (2014) Cardiotoxicity and oncological treatments. Dtsch Arztebl Int 111(10):161–168. https://doi.org/10.3238/arztebl.2014.0161 PubMedPubMedCentral

Kravchenko J, Berry M, Arbeev K, Kim Lyerly H, Yashin A, Akushevich I (2015) Cardiovascular comorbidities and survival of lung cancer patients: medicare data based analysis. Lung Cancer 88(1):85–93. https://doi.org/10.1016/j.lungcan.2015.01.006 CrossRefPubMedPubMedCentral

Hershman DL, McBride RB, Eisenberger A, Tsai WY, Grann VR, Jacobson JS (2008) Doxorubicin, cardiac risk factors, and cardiac toxicity in elderly patients with diffuse B-cell non-Hodgkin’s lymphoma. J Clin Oncol 26(19):3159–3165. https://doi.org/10.1200/JCO.2007.14.1242 CrossRefPubMed

Deng S, Wojnowski L (2007) Genotyping the risk of anthracycline-induced cardiotoxicity. Cardiovasc Toxicol 7(2):129–134. https://doi.org/10.1007/s12012-007-0024-2 CrossRefPubMed

Bhatia S (2011) Role of genetic susceptibility in development of treatment-related adverse outcomes in cancer survivors. Cancer Epidemiol Biomark Prev 20(10):2048–2067. https://doi.org/10.1158/1055-9965.EPI-11-0659 CrossRef

Cramer L, Hildebrandt B, Kung T, Wichmann K, Springer J, Doehner W, Sandek A, Valentova M, Stojakovic T, Scharnagl H, Riess H, Anker SD, von Haehling S (2014) Cardiovascular function and predictors of exercise capacity in patients with colorectal cancer. J Am Coll Cardiol 64(13):1310–1319. https://doi.org/10.1016/j.jacc.2014.07.948 CrossRefPubMed

Murphy KT (2016) The pathogenesis and treatment of cardiac atrophy in cancer cachexia. Am J Physiol Heart Circ Physiol 310(4):H466–H477. https://doi.org/10.1152/ajpheart.00720.2015 CrossRefPubMed

Aleman BM, Moser EC, Nuver J, Suter TM, Maraldo MV, Specht L, Vrieling C, Darby SC (2014) Cardiovascular disease after cancer therapy. EJC Suppl 12(1):18–28. https://doi.org/10.1016/j.ejcsup.2014.03.002 CrossRefPubMedPubMedCentral

Martin M, Esteva FJ, Alba E, Khandheria B, Perez-Isla L, Garcia-Saenz JA, Marquez A, Sengupta P, Zamorano J (2009) Minimizing cardiotoxicity while optimizing treatment efficacy with trastuzumab: review and expert recommendations. Oncologist 14(1):1–11. https://doi.org/10.1634/theoncologist.2008-0137 CrossRefPubMed

10.

Zamorano JL, Lancellotti P, Rodriguez Munoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GY, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM, Authors/Task Force M, Guidelines ESCCfP (2016) 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: the task force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. https://doi.org/10.1093/eurheartj/ehw211

11.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Rev Esp Cardiol (Engl Ed) 69(12):1167. https://doi.org/10.1016/j.rec.2016.11.005 CrossRef

12.

Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH (2014) Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review. J Am Coll Cardiol 63(25 Pt A):2751–2768. https://doi.org/10.1016/j.jacc.2014.01.073 CrossRefPubMed

13.

Ewer MS, Lippman SM (2005) Type II chemotherapy-related cardiac dysfunction: time to recognize a new entity. J Clin Oncol 23(13):2900–2902. https://doi.org/10.1200/JCO.2005.05.827 CrossRefPubMed

14.

Keefe DL (2002) Trastuzumab-associated cardiotoxicity. Cancer 95(7):1592–1600. https://doi.org/10.1002/cncr.10854 CrossRefPubMed

15.

Ewer MS, Ewer SM (2010) Cardiotoxicity of anticancer treatments: What the cardiologist needs to know. Nat Rev Cardiol 7(10):564–575. https://doi.org/10.1038/nrcardio.2010.121 CrossRefPubMed

16.

Dhesi S, Chu MP, Blevins G, Paterson I, Larratt L, Oudit GY, Kim DH (2013) Cyclophosphamide-induced cardiomyopathy: a case report, review, and recommendations for management. J Investig Med High Impact Case Rep 1(1):2324709613480346. https://doi.org/10.1177/2324709613480346 PubMedPubMedCentral

17.

Wouters KA, Kremer LC, Miller TL, Herman EH, Lipshultz SE (2005) Protecting against anthracycline-induced myocardial damage: a review of the most promising strategies. Br J Haematol 131(5):561–578. https://doi.org/10.1111/j.1365-2141.2005.05759.x CrossRefPubMed

18.

Minotti G, Cairo G, Monti E (1999) Role of iron in anthracycline cardiotoxicity: new tunes for an old song? FASEB J 13(2):199–212CrossRefPubMed

19.

Wojnowski L, Kulle B, Schirmer M, Schluter G, Schmidt A, Rosenberger A, Vonhof S, Bickeboller H, Toliat MR, Suk EK, Tzvetkov M, Kruger A, Seifert S, Kloess M, Hahn H, Loeffler M, Nurnberg P, Pfreundschuh M, Trumper L, Brockmoller J, Hasenfuss G (2005) NAD(P)H oxidase and multidrug resistance protein genetic polymorphisms are associated with doxorubicin-induced cardiotoxicity. Circulation 112(24):3754–3762. https://doi.org/10.1161/CIRCULATIONAHA.105.576850 CrossRefPubMed

20.

Swain SM, Whaley FS, Ewer MS (2003) Congestive heart failure in patients treated with doxorubicin—a retrospective analysis of three trials. Cancer 97(11):2869–2879. https://doi.org/10.1002/cncr.11407 CrossRefPubMed

21.

Hensley ML, Hagerty KL, Kewalramani T, Green DM, Meropol NJ, Wasserman TH, Cohen GI, Emami B, Gradishar WJ, Mitchell RB, Thigpen JT, Trotti A, 3rd, von Hoff D, Schuchter LM (2009) American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 27 (1):127–145. https://doi.org/10.1200/JCO.2008.17.2627 CrossRefPubMed

22.

Cardinale D, Colombo A, Bacchiani G, Tedeschi I, Meroni CA, Veglia F, Civelli M, Lamantia G, Colombo N, Curigliano G, Fiorentini C, Cipolla CM (2015) Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy. Circulation 131(22):1981–1988. https://doi.org/10.1161/CIRCULATIONAHA.114.013777 CrossRefPubMed

23.

Georgakopoulos P, Roussou P, Matsakas E, Karavidas A, Anagnostopoulos N, Marinakis T, Galanopoulos A, Georgiakodis F, Zimeras S, Kyriakidis M, Ahimastos A (2010) Cardioprotective effect of metoprolol and enalapril in doxorubicin-treated lymphoma patients: a prospective, parallel-group, randomized, controlled study with 36-month follow-up. Am J Hematol 85(11):894–896. https://doi.org/10.1002/ajh.21840 CrossRefPubMed

24.

Bosch X, Rovira M, Sitges M, Domenech A, Ortiz-Perez JT, de Caralt TM, Morales-Ruiz M, Perea RJ, Monzo M, Esteve J (2013) Enalapril and carvedilol for preventing chemotherapy-induced left ventricular systolic dysfunction in patients with malignant hemopathies: the OVERCOME trial (preventiOn of left Ventricular dysfunction with Enalapril and caRvedilol in patients submitted to intensive ChemOtherapy for the treatment of Malignant hEmopathies). J Am Coll Cardiol 61(23):2355–2362. https://doi.org/10.1016/j.jacc.2013.02.072 CrossRefPubMed

25.

Dessi M, Madeddu C, Piras A, Cadeddu C, Antoni G, Mercuro G, Mantovani G (2013) Long-term, up to 18 months, protective effects of the angiotensin II receptor blocker telmisartan on Epirubin-induced inflammation and oxidative stress assessed by serial strain rate. Springerplus 2(1):198. https://doi.org/10.1186/2193-1801-2-198 CrossRefPubMedPubMedCentral

26.

Yun S, Vincelette ND, Abraham I (2015) Cardioprotective role of beta-blockers and angiotensin antagonists in early-onset anthracyclines-induced cardiotoxicity in adult patients: a systematic review and meta-analysis. Postgrad Med J 91(1081):627–633. https://doi.org/10.1136/postgradmedj-2015-133535 CrossRefPubMed

27.

Gulati G, Heck SL, Ree AH, Hoffmann P, Schulz-Menger J, Fagerland MW, Gravdehaug B, von Knobelsdorff-Brenkenhoff F, Bratland A, Storas TH, Hagve TA, Rosjo H, Steine K, Geisler J, Omland T (2016) Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2 × 2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. Eur Heart J. https://doi.org/10.1093/eurheartj/ehw022

28.

Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd (2000) Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 160 (6):809–815CrossRefPubMed

29.

S2-Leitlinie: Diagnostik und Therapie der Venenthrombose und der Lungenembolie (2015)

30.

Khorana AA, Francis CW, Culakova E, Fisher RI, Kuderer NM, Lyman GH (2006) Thromboembolism in hospitalized neutropenic cancer patients. J Clin Oncol 24(3):484–490. https://doi.org/10.1200/JCO.2005.03.8877 CrossRefPubMed

31.

Kroger K, Weiland D, Ose C, Neumann N, Weiss S, Hirsch C, Urbanski K, Seeber S, Scheulen ME (2006) Risk factors for venous thromboembolic events in cancer patients. Ann Oncol 17(2):297–303. https://doi.org/10.1093/annonc/mdj068 CrossRefPubMed

32.

Blom JW, Doggen CJ, Osanto S, Rosendaal FR (2005) Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 293(6):715–722. https://doi.org/10.1001/jama.293.6.715 CrossRefPubMed

33.

Khorana AA, Francis CW, Culakova E, Lyman GH (2005) Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer 104(12):2822–2829. https://doi.org/10.1002/cncr.21496 CrossRefPubMed

34.

Chew HK, Wun T, Harvey D, Zhou H, White RH (2006) Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med 166(4):458–464. https://doi.org/10.1001/archinte.166.4.458 CrossRefPubMed

35.

Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, Dietrich-Neto F, Investigators EI (2002) Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med 346(13):975–980. https://doi.org/10.1056/NEJMoa012385 CrossRefPubMed

36.

Petrelli F, Cabiddu M, Borgonovo K, Barni S (2012) Risk of venous and arterial thromboembolic events associated with anti-EGFR agents: a meta-analysis of randomized clinical trials. Ann Oncol 23(7):1672–1679. https://doi.org/10.1093/annonc/mdr592 CrossRefPubMed

37.

Choueiri TK, Schutz FA, Je Y, Rosenberg JE, Bellmunt J (2010) Risk of arterial thromboembolic events with sunitinib and sorafenib: a systematic review and meta-analysis of clinical trials. J Clin Oncol 28(13):2280–2285. https://doi.org/10.1200/JCO.2009.27.2757 CrossRefPubMed

38.

Nalluri SR, Chu D, Keresztes R, Zhu X, Wu S (2008) Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis. JAMA 300(19):2277–2285. https://doi.org/10.1001/jama.2008.656 CrossRefPubMed

39.

Cortelezzi A, Moia M, Falanga A, Pogliani EM, Agnelli G, Bonizzoni E, Gussoni G, Barbui T, Mannucci PM, Group CS (2005) Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters: a prospective multicentre study. Br J Haematol 129(6):811–817. https://doi.org/10.1111/j.1365-2141.2005.05529.x CrossRefPubMed

40.

Moore RA, Adel N, Riedel E, Bhutani M, Feldman DR, Tabbara NE, Soff G, Parameswaran R, Hassoun H (2011) High incidence of thromboembolic events in patients treated with cisplatin-based chemotherapy: a large retrospective analysis. J Clin Oncol 29(25):3466–3473. https://doi.org/10.1200/JCO.2011.35.5669 CrossRefPubMed

41.

Lyman GH, Khorana AA, Falanga A, Clarke-Pearson D, Flowers C, Jahanzeb M, Kakkar A, Kuderer NM, Levine MN, Liebman H, Mendelson D, Raskob G, Somerfield MR, Thodiyil P, Trent D, Francis CW, American Society of Clinical O (2007) American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 25 (34):5490–5505. https://doi.org/10.1200/JCO.2007.14.1283 CrossRefPubMed

42.

Haas SK, Freund M, Heigener D, Heilmann L, Kemkes-Matthes B, von Tempelhoff GF, Melzer N, Kakkar AK, Investigators T (2012) Low-molecular-weight heparin versus placebo for the prevention of venous thromboembolism in metastatic breast cancer or stage III/IV lung cancer. Clin Appl Thromb Hemost 18(2):159–165. https://doi.org/10.1177/1076029611433769 CrossRefPubMed

43.

Bennett CL, Angelotta C, Yarnold PR, Evens AM, Zonder JA, Raisch DW, Richardson P (2006) Thalidomide- and lenalidomide-associated thromboembolism among patients with cancer. JAMA 296(21):2558–2560. https://doi.org/10.1001/jama.296.21.2558-c CrossRefPubMed

44.

Zangari M, Anaissie E, Barlogie B, Badros A, Desikan R, Gopal AV, Morris C, Toor A, Siegel E, Fink L, Tricot G (2001) Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 98(5):1614–1615CrossRefPubMed

45.

el-Shami K, Griffiths E, Streiff M (2007) Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment. Oncologist 12(5):518–523. https://doi.org/10.1634/theoncologist.12-5-518 CrossRefPubMed

46.

Singhal AB, Topcuoglu MA, Buonanno FS (2002) Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study. Stroke 33(5):1267–1273CrossRefPubMed

47.

Reagan TJ, Okazaki H (1974) The thrombotic syndrome associated with carcinoma. A clinical and neuropathologic study. Arch Neurol 31(6):390–395CrossRefPubMed

48.

Rogers LR, Cho ES, Kempin S, Posner JB (1987) Cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation. Am J Med 83(4):746–756CrossRefPubMed

49.

Lopez JA, Ross RS, Fishbein MC, Siegel RJ (1987) Nonbacterial thrombotic endocarditis: a review. Am Heart J 113(3):773–784CrossRefPubMed

50.

Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, Dulgheru R, El Khoury G, Erba PA, Iung B, Miro JM, Mulder BJ, Plonska-Gosciniak E, Price S, Roos-Hesselink J, Snygg-Martin U, Thuny F, Tornos Mas P, Vilacosta I, Zamorano JL, Document R, Erol C, Nihoyannopoulos P, Aboyans V, Agewall S, Athanassopoulos G, Aytekin S, Benzer W, Bueno H, Broekhuizen L, Carerj S, Cosyns B, De Backer J, De Bonis M, Dimopoulos K, Donal E, Drexel H, Flachskampf FA, Hall R, Halvorsen S, Hoen B, Kirchhof P, Lainscak M, Leite-Moreira AF, Lip GY, Mestres CA, Piepoli MF, Punjabi PP, Rapezzi C, Rosenhek R, Siebens K, Tamargo J, Walker DM (2015) 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the european society of cardiology (ESC). Endorsed by: European association for cardio-thoracic surgery (EACTS), the European association of nuclear medicine (EANM). Eur Heart J 36(44):3075–3128. https://doi.org/10.1093/eurheartj/ehv319 CrossRefPubMed

51.

Thomsen RW, Farkas DK, Friis S, Svaerke C, Ording AG, Norgaard M, Sorensen HT (2013) Endocarditis and risk of cancer: a Danish nationwide cohort study. Am J Med 126(1):58–67. https://doi.org/10.1016/j.amjmed.2012.07.026 CrossRefPubMed

52.

Shen C, Shih YC, Xu Y, Yao JC (2014) Octreotide long-acting repeatable use among elderly patients with carcinoid syndrome and survival outcomes: a population-based analysis. Cancer 120(13):2039–2049. https://doi.org/10.1002/cncr.28653 CrossRefPubMed

53.

Connolly HM, Schaff HV, Abel MD, Rubin J, Askew JW, Li Z, Inda JJ, Luis SA, Nishimura RA, Pellikka PA (2015) Early and late outcomes of surgical treatment in carcinoid heart disease. J Am Coll Cardiol 66(20):2189–2196. https://doi.org/10.1016/j.jacc.2015.09.014 CrossRefPubMed

54.

Adler Y, Charron P (2015) The 2015 ESC Guidelines on the diagnosis and management of pericardial diseases. Eur Heart J 36(42):2873–2874. https://doi.org/10.1093/eurheartj/ehv479 CrossRefPubMed

55.

Maisch B, Ristic A, Pankuweit S (2010) Evaluation and management of pericardial effusion in patients with neoplastic disease. Prog Cardiovasc Dis 53(2):157–163. https://doi.org/10.1016/j.pcad.2010.06.003 CrossRefPubMed

56.

Vaitkus PT, Herrmann HC, LeWinter MM (1994) Treatment of malignant pericardial effusion. JAMA 272(1):59–64CrossRefPubMed

57.

Stewart JR, Fajardo LF, Gillette SM, Constine LS (1995) Radiation injury to the heart. Int J Radiat Oncol Biol Phys 31(5):1205–1211. https://doi.org/10.1016/0360-3016(94)00656-6 CrossRefPubMed

58.

Adler Y, Charron P, Imazio M, Badano L, Baron-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristic AD, Sabate Tenas M, Seferovic P, Swedberg K, Tomkowski W, Achenbach S, Agewall S, Al-Attar N, Angel Ferrer J, Arad M, Asteggiano R, Bueno H, Caforio AL, Carerj S, Ceconi C, Evangelista A, Flachskampf F, Giannakoulas G, Gielen S, Habib G, Kolh P, Lambrinou E, Lancellotti P, Lazaros G, Linhart A, Meurin P, Nieman K, Piepoli MF, Price S, Roos-Hesselink J, Roubille F, Ruschitzka F, Sagrista Sauleda J, Sousa-Uva M, Uwe Voigt J, Luis Zamorano J, European Society of C (2015) 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 36 (42):2921–2964. https://doi.org/10.1093/eurheartj/ehv318 CrossRefPubMed

59.

Bishiniotis TS, Antoniadou S, Katseas G, Mouratidou D, Litos AG, Balamoutsos N (2000) Malignant cardiac tamponade in women with breast cancer treated by pericardiocentesis and intrapericardial administration of triethylenethiophosphoramide (thiotepa). Am J Cardiol 86(3):362–364CrossRefPubMed

60.

Kunitoh H, Tamura T, Shibata T, Imai M, Nishiwaki Y, Nishio M, Yokoyama A, Watanabe K, Noda K, Saijo N, Jcog Lung Cancer Study Group TJ (2009) A randomised trial of intrapericardial bleomycin for malignant pericardial effusion with lung cancer (JCOG9811). Br J Cancer 100(3):464–469. https://doi.org/10.1038/sj.bjc.6604866 CrossRefPubMedPubMedCentral

61.

Herrmann J, Yang EH, Iliescu CA, Cilingiroglu M, Charitakis K, Hakeem A, Toutouzas K, Leesar MA, Grines CL, Marmagkiolis K (2016) Vascular toxicities of cancer therapies: the old and the new—an evolving avenue. Circulation 133(13):1272–1289. https://doi.org/10.1161/CIRCULATIONAHA.115.018347 CrossRefPubMedPubMedCentral

62.

Izzedine H, Ederhy S, Goldwasser F, Soria JC, Milano G, Cohen A, Khayat D, Spano JP (2009) Management of hypertension in angiogenesis inhibitor-treated patients. Ann Oncol 20(5):807–815. https://doi.org/10.1093/annonc/mdn713 CrossRefPubMed

63.

Small HY, Montezano AC, Rios FJ, Savoia C, Touyz RM (2014) Hypertension due to antiangiogenic cancer therapy with vascular endothelial growth factor inhibitors: understanding and managing a new syndrome. Can J Cardiol 30(5):534–543. https://doi.org/10.1016/j.cjca.2014.02.011 CrossRefPubMed

64.

Hansen ES (1990) International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC Working Paper 7/1/2. Shared risk factors for cancer and atherosclerosis—a review of the epidemiological evidence. Mutat Res 239(3):163–179CrossRefPubMed

65.

Haugnes HS, Wethal T, Aass N, Dahl O, Klepp O, Langberg CW, Wilsgaard T, Bremnes RM, Fossa SD (2010) Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol 28(30):4649–4657. https://doi.org/10.1200/JCO.2010.29.9362 CrossRefPubMed

66.

Meinardi MT, Gietema JA, van der Graaf WT, van Veldhuisen DJ, Runne MA, Sluiter WJ, de Vries EG, Willemse PB, Mulder NH, van den Berg MP, Koops HS, Sleijfer DT (2000) Cardiovascular morbidity in long-term survivors of metastatic testicular cancer. J Clin Oncol 18(8):1725–1732CrossRefPubMed

67.

Samuels BL, Vogelzang NJ, Kennedy BJ (1987) Severe vascular toxicity associated with vinblastine, bleomycin, and cisplatin chemotherapy. Cancer Chemother Pharmacol 19(3):253–256CrossRefPubMed

68.

Arima Y, Oshima S, Noda K, Fukushima H, Taniguchi I, Nakamura S, Shono M, Ogawa H (2009) Sorafenib-induced acute myocardial infarction due to coronary artery spasm. J Cardiol 54(3):512–515. https://doi.org/10.1016/j.jjcc.2009.03.009 CrossRefPubMed

69.

Gemici G, Cincin A, Degertekin M, Oktay A (2009) Paclitaxel-induced ST-segment elevations. Clin Cardiol 32(6):E94–E96. https://doi.org/10.1002/clc.20291 CrossRefPubMed

70.

Shah K, Gupta S, Ghosh J, Bajpai J, Maheshwari A (2012) Acute non-ST elevation myocardial infarction following paclitaxel administration for ovarian carcinoma: a case report and review of literature. J Cancer Res Ther 8(3):442–444. https://doi.org/10.4103/0973-1482.103530 CrossRefPubMed

71.

Darby SC, Ewertz M, Hall P (2013) Ischemic heart disease after breast cancer radiotherapy. N Engl J Med 368(26):2527. https://doi.org/10.1056/NEJMc1304601 CrossRefPubMed

72.

Castellino SM, Geiger AM, Mertens AC, Leisenring WM, Tooze JA, Goodman P, Stovall M, Robison LL, Hudson MM (2011) Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study. Blood 117(6):1806–1816. https://doi.org/10.1182/blood-2010-04-278796 CrossRefPubMedPubMedCentral

73.

Swerdlow AJ, Higgins CD, Smith P, Cunningham D, Hancock BW, Horwich A, Hoskin PJ, Lister A, Radford JA, Rohatiner AZ, Linch DC (2007) Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. J Natl Cancer Inst 99(3):206–214. https://doi.org/10.1093/jnci/djk029 CrossRefPubMed

74.

Cheng SW, Ting AC, Ho P, Wu LL (2004) Accelerated progression of carotid stenosis in patients with previous external neck irradiation. J Vasc Surg 39(2):409–415. https://doi.org/10.1016/j.jvs.2003.08.031 CrossRefPubMed

75.

AWMF (Stand: 08.08.2012) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der extracraniellen Carotisstenose

76.

Tallarita T, Oderich GS, Lanzino G, Cloft H, Kallmes D, Bower TC, Duncan AA, Gloviczki P (2011) Outcomes of carotid artery stenting versus historical surgical controls for radiation-induced carotid stenosis. J Vasc Surg 53(3):629–636. https://doi.org/10.1016/j.jvs.2010.09.056 (e621–625) CrossRefPubMed

77.

Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M, Aboyans V, Vaz Carneiro A, Achenbach S, Agewall S, Allanore Y, Asteggiano R, Paolo Badano L, Albert Barbera J, Bouvaist H, Bueno H, Byrne RA, Carerj S, Castro G, Erol C, Falk V, Funck-Brentano C, Gorenflo M, Granton J, Iung B, Kiely DG, Kirchhof P, Kjellstrom B, Landmesser U, Lekakis J, Lionis C, Lip GY, Orfanos SE, Park MH, Piepoli MF, Ponikowski P, Revel MP, Rigau D, Rosenkranz S, Voller H, Luis Zamorano J (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119. https://doi.org/10.1093/eurheartj/ehv317 CrossRefPubMed

78.

Tamargo J, Caballero R, Delpon E (2015) Cancer chemotherapy and cardiac arrhythmias: a review. Drug Saf 38(2):129–152. https://doi.org/10.1007/s40264-014-0258-4 CrossRefPubMed

79.

Jurczak W, Szmit S, Sobocinski M, Machaczka M, Drozd-Sokolowska J, Joks M, Dzietczenia J, Wrobel T, Kumiega B, Zaucha JM, Knopinska-Posluszny W, Spychalowicz W, Prochwicz A, Drohomirecka A, Skotnicki AB (2013) Premature cardiovascular mortality in lymphoma patients treated with (R)-CHOP regimen—a national multicenter study. Int J Cardiol 168(6):5212–5217. https://doi.org/10.1016/j.ijcard.2013.08.033 CrossRefPubMed

80.

Kilickap S, Barista I, Akgul E, Aytemir K, Aksoy S, Tekuzman G (2007) Early and late arrhythmogenic effects of doxorubicin. South Med J 100(3):262–265. https://doi.org/10.1097/01.smj.0000257382.89910.fe CrossRefPubMed

81.

Arbuck SG, Strauss H, Rowinsky E, Christian M, Suffness M, Adams J, Oakes M, McGuire W, Reed E, Gibbs H et al. (1993) A reassessment of cardiac toxicity associated with Taxol. J Natl Cancer Inst Monogr (15):117–130

82.

Ando M, Yokozawa T, Sawada J, Takaue Y, Togitani K, Kawahigashi N, Narabayashi M, Takeyama K, Tanosaki R, Mineishi S, Kobayashi Y, Watanabe T, Adachi I, Tobinai K (2000) Cardiac conduction abnormalities in patients with breast cancer undergoing high-dose chemotherapy and stem cell transplantation. Bone Marrow Transplant 25(2):185–189. https://doi.org/10.1038/sj.bmt.1702106 CrossRefPubMed

83.

Barbey JT, Pezzullo JC, Soignet SL (2003) Effect of arsenic trioxide on QT interval in patients with advanced malignancies. J Clin Oncol 21(19):3609–3615. https://doi.org/10.1200/JCO.2003.10.009 CrossRefPubMed

84.

Westervelt P, Brown RA, Adkins DR, Khoury H, Curtin P, Hurd D, Luger SM, Ma MK, Ley TJ, DiPersio JF (2001) Sudden death among patients with acute promyelocytic leukemia treated with arsenic trioxide. Blood 98(2):266–271CrossRefPubMed

85.

Kantarjian H, Giles F, Wunderle L, Bhalla K, O’Brien S, Wassmann B, Tanaka C, Manley P, Rae P, Mietlowski W, Bochinski K, Hochhaus A, Griffin JD, Hoelzer D, Albitar M, Dugan M, Cortes J, Alland L, Ottmann OG (2006) Nilotinib in imatinib-resistant CML and Philadelphia chromosome-positive ALL. N Engl J Med 354(24):2542–2551. https://doi.org/10.1056/NEJMoa055104 CrossRefPubMed

86.

Larsen RL, Jakacki RI, Vetter VL, Meadows AT, Silber JH, Barber G (1992) Electrocardiographic changes and arrhythmias after cancer therapy in children and young adults. Am J Cardiol 70(1):73–77CrossRefPubMed

87.

Jaworski C, Mariani JA, Wheeler G, Kaye DM (2013) Cardiac complications of thoracic irradiation. J Am Coll Cardiol 61(23):2319–2328. https://doi.org/10.1016/j.jacc.2013.01.090 CrossRefPubMed

88.

Anker MS, Ebner N, Hildebrandt B, Springer J, Sinn M, Riess H, Anker SD, Landmesser U, Haverkamp W, von Haehling S (2016) Resting heart rate is an independent predictor of death in patients with colorectal, pancreatic, and non-small cell lung cancer: results of a prospective cardiovascular long-term study. Eur J Heart Fail 18(12):1524–1534. https://doi.org/10.1002/ejhf.670 CrossRefPubMed

Title: Cardio-oncology: conflicting priorities of anticancer treatment and cardiovascular outcome
Authors: Lisa M. Tilemann
Markus B. Heckmann
Hugo A. Katus
Lorenz H. Lehmann
Oliver J. Müller
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 4/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1202-x

ACC 2024 Congress Coverage

Cardiology Video

Highlights from the ACC 2024 Congress

Watch now

Watch official videos from the ACC congress summarizing key highlights from the last year in heart failure, cardiomyopathies, valvular disease, pulmonary vascular disease, and pediatric cardiology.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 4/2018

Trends in mechanical circulatory support use and hospital mortality among patients with acute myocardial infarction and non-infarction related cardiogenic shock in the United States

Association between left atrial phasic conduit function and early atrial fibrillation recurrence in patients undergoing electrical cardioversion

Circadian dependence of manual thrombus aspiration benefit in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Effects of the intensity of prehospital treatment on short-term outcomes in patients with acute heart failure: the SEMICA-2 study