State-of-the-Art Paper
Cardiovascular Complications of Cancer Therapy: Incidence, Pathogenesis, Diagnosis, and Management

https://doi.org/10.1016/j.jacc.2009.02.050Get rights and content
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Cancer treatment today employs a combination of chemotherapy, radiotherapy, and surgery to prolong life and provide cure. However, many of these treatments can cause cardiovascular complications such as heart failure, myocardial ischemia/infarction, hypertension, thromboembolism, and arrhythmias. In this article we review the incidence of cardiotoxicity caused by commonly used chemotherapeutic agents as well as discuss the pathogenesis, diagnosis, management, and prevention of these cardiovascular side effects. Cardiotoxicity related to anticancer treatment is important to recognize as it may have a significant impact on the overall prognosis and survival of cancer patients, and it is likely to remain a significant challenge for both cardiologists and oncologists in the future due to an increasing aging population of patients with cancer and the introduction of many new cancer therapies.

Key Words

cancer
cardiotoxicity
therapy
heart failure

Abbreviations and Acronyms

ACE
angiotensin-converting enzyme
ACS
acute coronary syndrome
ATE
arterial thrombotic event
ATP
adenosine triphosphate
CMP
cardiomyopathy
CTCL
cutaneous T-cell lymphoma
DVT
deep vein thrombosis
FDA
Food and Drug Administration
HF
heart failure
HTN
hypertension
LMWH
low-molecular-weight heparin
LVD
left ventricular dysfunction
LVEF
left ventricular ejection fraction
MI
myocardial infarction
MUGA
multigated acquisition scan
PE
pulmonary embolism
VEGF
vascular endothelial growth factor
VTE
venous thromboembolism
5-FU
5-fluorouracil

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Dr. Yeh is a consultant for Celgene and is the McNair Scholar of the Texas Heart Institute.