Cardiovascular complications of cancer therapy: diagnosis, pathogenesis, and management.
The cardiotoxicity of anticancer agents can lead to significant complications that can affect patients being treated for various malignancies. The severity of such toxicity depends on many factors such as the molecular site of action, the immediate and cumulative dose, the method of administration, the presence of any underlying cardiac condition, and the demographics of the patient. Moreover, toxicity can be affected by current or previous treatment with other antineoplastic agents. Cardiotoxic effects can occur immediately during administration of the drug, or they may not manifest themselves until months or years after the patient has been treated. In this article we review commonly used chemotherapy agents, including several recently approved medications, for their propensity to cause cardiotoxicity. Further research will be required to more accurately predict which patients are at risk for developing cardiotoxicity. In addition, management plans, as well as strategies to reduce cardiotoxicity, need to be developed.
Yeh
Edward T H
ET
Department of Cardiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Tex 77030-4095, USA. etyeh@mdanderson.org
Tong
Ann T
AT
Lenihan
Daniel J
DJ
Yusuf
S Wamique
SW
Swafford
Joseph
J
Champion
Christopher
C
Durand
Jean-Bernard
JB
Gibbs
Harry
H
Zafarmand
Alireza Atef
AA
Ewer
Michael S
MS
D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D001706:Biopsy; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D016207:Cytokines / Q000009:adverse effects / Q000627:therapeutic use; D006321:Heart / Q000528:radiation effects; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy; D010496:Pericardium / Q000528:radiation effects; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D011929:Razoxane / Q000627:therapeutic use; D012307:Risk Factors
D018943:Anthracyclines; D000911:Antibodies, Monoclonal; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D015415:Biomarkers; D016207:Cytokines; D011929:Razoxane