Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer

IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Jacc: Cardiooncology Pub Date : 2024-02-01 DOI:10.1016/j.jaccao.2023.12.008
Rawan A. Hammoud MD , Daniel A. Mulrooney MD, MS , Isaac B. Rhea MD , Christine Yu MD , Jason N. Johnson MD, MHSc , Eric J. Chow MD, MPH , Matthew J. Ehrhardt MD, MS , Melissa M. Hudson MD , Kirsten K. Ness PhD , Gregory T. Armstrong MD, MSCE , Stephanie B. Dixon MD, MPH
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Abstract

The growing community of childhood cancer survivors faces a heavy burden of late onset morbidities and mortality, with cardiovascular diseases being the leading noncancer cause. In addition to demographics and cancer treatment exposures, which cannot be altered, cardiometabolic risk factors (obesity, hypertension, diabetes, and dyslipidemia) and frailty potentiate the risk of morbidity and mortality associated with chronic health conditions. Important opportunities exist to target these risk factors and improve late health outcomes for survivors. Unfortunately, limited evidence exists on the optimal methods to prevent, screen, and treat cardiometabolic risk factors among survivors, resulting in significant underdiagnosis and undertreatment. In this review, we discuss the prevalence of, risk factors for, current survivor-specific recommendations, and gaps in knowledge to mitigate potentially modifiable cardiometabolic risk factors and frailty among survivors of childhood cancer.

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儿童癌症幸存者可改变的心脏代谢风险因素
越来越多的儿童癌症幸存者面临着晚期发病和死亡的沉重负担,其中心血管疾病是主要的非癌症原因。除了无法改变的人口统计学和癌症治疗暴露外,心脏代谢风险因素(肥胖、高血压、糖尿病和血脂异常)和虚弱也会增加与慢性健康状况相关的发病和死亡风险。针对这些风险因素并改善幸存者的后期健康状况存在着重要的机会。遗憾的是,有关预防、筛查和治疗幸存者心血管代谢风险因素的最佳方法的证据有限,这导致了严重的诊断不足和治疗不足。在这篇综述中,我们将讨论儿童癌症幸存者中心脏代谢风险因素和虚弱的患病率、风险因素、当前针对幸存者的建议以及在缓解潜在可改变的心脏代谢风险因素和虚弱方面的知识差距。
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来源期刊
CiteScore
12.50
自引率
6.30%
发文量
106
期刊介绍: JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge. The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention. Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.
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