title: Routine Prophylactic Cardioprotective Therapy Should Not Be Given to All Recipients of Potentially Cardiotoxic Cancer Chemotherapy.
abstract: With growing recognition of the associations between cancer therapy and cardiotoxicity, attention has increasingly focused on the prevention of cancer therapy-related cardiovascular disease. Various strategies for cardioprotection have been proposed, including routine administration of therapies such as inhibitors of the renin-angiotensin-aldosterone system and β-blockers. We argue this approach is unsupported by the evidence and will be associated with a high likelihood of adverse effects. We highlight alternate strategies for managing this emerging issue, which focus on a targeted approach to primary prevention driven by early identification of cardiotoxicity and selective prophylaxis of patients at increased risk for developing cardiotoxicity.
authors.affiliation: Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Margot K
authors.initials: MK
authors.lastname: Davis
authors.affiliation: Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: svirani@telus.net.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Virani
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D066126:Cardiotoxicity / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003952:Diagnostic Imaging; D042241:Early Diagnosis; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D018579:Patient Selection; D011322:Primary Prevention; D018570:Risk Assessment; D055502:Secondary Prevention; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis
chemical_list: D000970:Antineoplastic Agents; D002316:Cardiotonic Agents