Cardio-oncology最新文献

Background: Among Asian, Native Hawaiian, and Pacific Islanders (ANHPI) in the United States, cancer and cardiovascular disease are the leading causes of death. Colorectal cancer (CRC) is the third most common cancer among ANHPIs, with improving survival rates. However, the risk of cardiovascular disease (CVD) events among ANHPI CRC survivors is unknown, especially within disaggregated ANHPI race and ethnicity groups.

Methods: We estimated the risk of CVD events among ANHPI CRC survivors within the SEER-Medicare database. Composite CVD, heart failure, ischemic heart disease, and stroke/transient ischemic attack were identified using International Classification of Diseases (ICD) diagnostic codes. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for CVD events among ANHPI regional subgroups.

Results: Compared to non-Hispanic White (NHW) CRC survivors, the risk of composite CVD was lower among East and Southeast Asian CRC survivors at > 1 years after initial cancer diagnosis. The risk of composite CVD, heart failure, and ischemic heart disease were lower among East and Southeast Asians for follow-up > 5 years. When compared to East Asians, NHW and Southeast Asian CRC survivors had a higher risk of composite CVD, heart failure, and ischemic heart disease where South Asians had a higher risk of ischemic heart disease.

Conclusions: Within the disaggregated ANHPI race and ethnicity groups of CRC survivors, our results support heterogeneity of incident CVD events. Further research is needed to develop public health interventions to address the disparities in CVD risk, especially among the high-risk groups of South Asian and Southeast Asian CRC survivors.

Anthracycline chemotherapy is commonly used to treat cancer in both adult and pediatric patients. While effective, anthracycline treatment is associated with a high risk of cardiotoxicity, often manifesting as a decline in left ventricular function, resulting in long term cardiovascular complications. Aerobic exercise has been studied extensively for its cardioprotective benefits in patients with anthracycline-induced cardiac dysfunction; however, the role of resistance training remains unexplored and controversial due to historical concerns regarding safety. This systematic review examined the existing literature on the effects and safety of resistance training in pediatric and adult cancer patients treated with anthracyclines. A two-part screening process was completed in Covidence (2025), starting with the screening of titles and abstracts, followed by the full-text screening. Eight studies, all incorporating AR-T were reviewed. The findings suggest that AR-T is safe and well-tolerated, with no evidence indicating that resistance training exacerbates cardiac dysfunction. No studies included exclusively pediatric or adolescent patients, limiting the generalizability of the findings to these populations. Randomized controlled trials focused solely on resistance training are needed to inform future clinical guidelines.

Purpose: The purpose of this systematic review and meta-analysis is to explore the utilization of cardioprotective medications in patients treated with RT and assess their impact on cardiovascular and cerebrovascular events.

Materials/methods: A literature search of PubMed, Embase and Scopus was performed in March 2025. Studies of adult patients treated with RT to the head and neck or thoracic regions which investigated the effects of cardioprotective medications (defined as anti-hypertensives, lipid-lowering therapies or anti-thrombotic medications) on the incidence of cardiovascular or cerebrovascular events were eligible for inclusion. Studies that reported the proportion of patients treated with RT who were utilizing cardioprotective medications as recommended by CVD guidelines were also included. Meta-analysis was performed using R with a random effects model.

Results: There were 10 retrospective studies which were eligible for inclusion. Five of the ten studies included patients with head and neck cancer only, whilst two studies included patients with lung cancer and one study included patients with breast cancer alone. Meta-analysis of three studies suggested that patients treated with RT who received statin therapy had a reduced risk of cerebrovascular events (stroke or transient ischemic attack), with a relative risk of 0.74 (95% CI 0.60-0.90). There was no difference in major adverse cardiac events (MACE) for patients treated with RT to the head and neck or thoracic regions who received statin therapy compared to those who did not (relative risk 0.99, 95% CI 0.67 to 1.46, n = 5 studies). A meta-analysis of four studies suggested that 59% (95% CI 35% to 80%) of patients treated with RT not on statin therapy had indications for commencement of these medications.

Conclusion: Current evidence exploring the impact of cardioprotective medications on CVD risk in patients treated with RT is heterogenous and limited to retrospective non-randomized studies. A considerable proportion of patients undergoing RT are not being prescribed cardioprotective medications as suggested by existing CVD guidelines.

Introduction: Anthracycline-induced cardiotoxicity (AIC) is a serious complication of chemotherapy, and there is a need for cost-effective biomarkers to enable risk stratification. Serum neprilysin (sNEP) has been investigated as a biomarker in various cardiovascular conditions, but its role in AIC has not been evaluated.

Methods: Twelve-week-old Sprague-Dawley rats received intraperitoneal doxorubicin (DOX) either as a single 20 mg/kg dose (acute model, n = 8), four weekly doses of 5 mg/kg (chronic model, n = 11), or saline (controls, n = 8 for each model). Echocardiography was performed at baseline and on the final study day. Blood and left ventricular (LV) tissue were collected within 24 h (acute model) or one week (chronic model) after the last injection. NEP protein and mRNA expression were measured in LV tissue, and sNEP concentrations were determined in serum.

Results: In the chronic AIC model, LV NEP protein expression was significantly reduced compared with controls (982.56 ± 90.57 vs. 1132.86 ± 132.30 ng/L, p < 0.05). In the acute model, sNEP levels showed a strong positive correlation with the severity of LV cardiomyocyte vacuolization (rs = 0.81, p < 0.05). In the chronic model, sNEP levels were strongly and negatively correlated with cardiac output (r = - 0.91, p < 0.05).

Conclusions: Chronic DOX exposure reduces LV NEP protein expression. Elevated serum sNEP is associated with greater early cardiomyocyte injury, while in chronic AIC, it correlates with a more severe decline in cardiac output. These findings suggest sNEP may be a potential biomarker for AIC.