ABSTRACT
Oncocardiology is an emerging field in cardiovascular healthcare. Besides establishing surveillance and follow-up strategies for cancer patients, it will be essential to set up specialized oncocardiology services. However, there is a lack of clinical studies to give evidence-based recommendations regarding cardiological diagnostic and therapeutic approaches for cancer patients. An oncocardiology service is a patient-centered structure that aims to integrate research and interdisciplinary patient care to bridge this gap. We discuss the current challenges in developing an oncocardiology service and review the literature on this topic. We further provide an overview of the essential diagnostic tools and upcoming ethical issues to be considered in the management of oncology patients.
PMID:32572500 | PMC:PMC7306932 | DOI:10.1007/s00059-020-04952-w
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PubMed articles on: Cancer & VTE/PE
Direct oral anticoagulants and cancer-associated VTE: good for all, or just some?
20:08
PubMed articles on: Cardio-Oncology
Cardio-oncology: the new frontier of clinical and preventive cardiology
20:08
PubMed articles on: Cardio-Oncology
SGLT2i: beyond the glucose-lowering effect
20:08
PubMed articles on: Cardio-Oncology
The microRNA-34a-Induced Senescence-Associated Secretory Phenotype (SASP) Favors Vascular Smooth Muscle Cells Calcification
20:08
PubMed articles on: Cancer & VTE/PE
Clinical effect of bronchial arterial infusion chemotherapy and CalliSpheres drug-eluting beads in patients with stage II-IV lung cancer: A prospective cohort study
Shang B, et al. Thorac Cancer 2020.
ABSTRACT
BACKGROUND: CalliSpheres are drug-eluting beads used for tumor artery embolization, with clinical benefits in a number of cancer types. The aim of the study was to examine the clinical benefits and complications of patients with stage II-IV lung cancer treated with CalliSpheres drug-eluting beads for embolization versus conventional vascular interventional treatment.
METHODS: This was a prospective cohort study conducted from August 2018 to May 2019. The patients were grouped according to traditional bronchial arterial infusion chemotherapy (infusion group) or bronchial arterial chemoembolization with CalliSpheres drug-eluting beads loaded with adriamycin (CallisSphere group). Short-term effects, serum tumor markers, and adverse reactions during follow-up were compared between the two groups.
RESULTS: There were 60 participants enrolled into the study with 30 in each group including 54 men and six women, 42-78 years of age. In the CalliSphere group, compared with the infusion group, the disease control rate was 93.3% versus 73.3% (P = 0.080) and the objective remission rate (ORR) was 86.7% versus 60.0% (P = 0.039); the three- and six-month progression-free survival (PFS) and six-month overall survival (OS) were better in the CalliSphere group (three-month PFS: 96.7% vs. 73.3%, P = 0.026; six-month PFS: 87.5% vs. 57.1%, P = 0.045; six-month OS: 87.5% vs. 52.7%, P = 0.024); after treatment, the tumor markers in the CalliSphere group were lower (CEA: P < 0.001; CYFRA21-1: P = 0.014). There were no differences in adverse reactions between the two groups.
CONCLUSIONS: The clinical effect of bronchial arterial chemoembolization with drug-eluting beads on lung cancer is probably significant and could improve the short-term response, PFS, and OS in patients with stage IIIV lung cancer, without increasing severe adverse reactions.
KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: The clinical effect of bronchial arterial chemoembolization with drug-eluting beads on lung cancer is probably significant and could improve the short-term response, PFS, and OS in patients with stage II-IV lung cancer, without increasing severe adverse reactions.
WHAT THIS STUDY ADDS: The ORR, PFS, OS was better in the CalliSphere group than that of infusion group; CEA and CYFRA21-1 were significant lower in CalliSphere group.
PMID:32603550 | DOI:10.1111/1759-7714.13522
20:08
PubMed articles on: Cancer & VTE/PE
Prevention of thromboembolic disease in elderly patients admitted to medical wards
Lopez-Picazo Ferrer JJ, et al. J Healthc Qual Res 2020.
ABSTRACT
OBJECTIVES: To determine the suitability of the prevention of thromboembolic disease in elderly patients admitted to medical departments, as well as some associated factors, such as the measures required in order to improve quality and safety.
PATIENTS AND METHODS: A retrospective study in a tertiary level hospital that included elderly patients that were admitted to medical departments. A simple, non-proportional, randomised sample was used, stratified by department. The risk was measured using the Padua prediction model and the risk assessment model of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) adjusting depending on the number of discharges. A Lot Quality Assurance Sampling (LQAS) plan was used with three levels, good, (standard 95%, threshold 70%), acceptable (standard 95%, threshold 50%), and not acceptable.
RESULTS: A total of 72 cases from 8 departments were evaluated. Just over half (51.4%) of patients had a high risk of thromboembolic disease (Padua≥4), and 23.6% of bleeding (IMPROVE≥7). Besides the advanced age, the adjusted scores were particularly due to cancer (22%) and reduced mobility (19%) for Padua, and male gender (13%) and renal failure (12%) for IMPROVE. The adjusted overall suitability was 57.5% (95%CI: ±19.0%). The OR for suitable conduct on not starting medication, 1.56 (95%CI: 1.07-2.26). The suitability by department was not uniform: all the lots were acceptable, in 3 with level "good" and in 5 with "acceptable".
CONCLUSIONS: The suitability of thromboembolic prophylaxis in the study hospital maintains acceptable levels, although not homogeneous. There is an opportunity for improvement that must be taken. The data obtained may help in deciding interventions, with LQAS being useful to optimise the evaluation effort.
PMID:32593592 | DOI:10.1016/j.jhqr.2019.11.006
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PubMed articles on: Cardio-Oncology
Cardiovascular Toxicities of Bruton's Tyrosine Kinase Inhibitors
Pineda-Gayoso R, et al. Curr Treat Options Oncol 2020 - Review.
ABSTRACT
There has been a significant shift in the management of B cell malignancies over the past decade. Initial strategies involving the use of systemic chemotherapies have been gradually replaced by more targeted therapies to improve survival and overall tolerability. Bruton's tyrosine kinase inhibitors are breakthrough drugs that have been approved to treat many B cell malignancies. Despite their demonstrated benefits, unintended events still occur including various cardiotoxicities. In this review, we discuss the rationale behind developing these agents, their common cardiovascular toxicities, and associated management challenges.
PMID:32607825 | DOI:10.1007/s11864-020-00764-6
20:08
PubMed articles on: Cardio-Oncology
Sacubitril/valsartan in the treatment of cancer therapy-related cardiac dysfunction
Wang Y, et al. Int J Cardiol 2020.
NO ABSTRACT
PMID:32610154 | DOI:10.1016/j.ijcard.2020.06.041
20:08
PubMed articles on: Cardio-Oncology
Pluripotent Stem Cell Modeling of Anticancer Therapy-Induced Cardiotoxicity
4 July 2020
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Cardiotoxicity News
PubMed articles on: Cardio-Oncology
Cardio-oncology - More than just cardiac complications of cancer treatment
Ghosh AK. Int J Cardiol 2020.
NO ABSTRACT
PMID:32544476 | DOI:10.1016/j.ijcard.2020.06.003
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PubMed articles on: Cancer & VTE/PE
Adverse Events and Mortality in Anticoagulated Patients with Different Categories of Pulmonary Embolism
Cambron JC, et al. Mayo Clin Proc Innov Qual Outcomes 2020.
ABSTRACT
OBJECTIVE: To determine whether the pulmonary embolism (PE) categories of massive, submassive, PE with no right ventricle dysfunction (NRVD), and subsegmental only (SSO) adequately predict clinical outcome.
METHODS: Patients treated for acute PE (March 1, 2013, through July 31, 2019) were followed forward prospectively to compare venous thromboembolism (VTE) recurrence, all-cause mortality, major bleeding, and clinically relevant nonmajor bleeding (CRNMB) across 4 PE categories.
RESULTS: Of 2703 patients with VTE, 1188 (44%) had PE, of which 1021 (85.9%) completed at least 3 months of therapy or had clinical outcomes precluding further treatment (27 with massive, 217 submassive, 557 NRVD, and 220 SSO PE). One patient with massive, 8 with submassive, 23 with NRVD, and 5 with SSO PE had recurrent VTE (3.90, 5.33, 5.36, and 3.66 per 100 person-years, respectively; P=.84). There were 3 deaths in massive, 27 in submassive, 140 in NRVD, and 34 in SSO PE groups (11.59, 17.37, 31.74, and 24.74 per 100 person-years, respectively; P=.02); when adjusted for cancer, the relationship was no longer significant (P=.27). One patient with massive, 5 with submassive, 22 with NRVD, and 5 with SSO PE had major bleeding (3.90, 3.31, 5.24, and 3.75 per 100 person-years, respectively; P=.66). Similar cumulative rates for CRNMB were observed (P=.87). Three-month rates of VTE recurrence, death, major bleeding, and CRNMB did not differ by PE category.
CONCLUSION: In the setting of anticoagulation therapy with maximal standardization and evidence-based practice, there is no evidence of a difference between PE categories and outcomes.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03504007.
PMID:32542216 | PMC:PMC7283932 | DOI:10.1016/j.mayocpiqo.2020.02.002
00:10
PubMed articles on: Cancer & VTE/PE
Infantile hepatic hemangioendothelioma associated with pulmonary artery hypertension and cardiac insufficiency successfully treated with transcatheter arterial embolization and propranolol: A case report
Wang L, et al. Medicine (Baltimore) 2020.
ABSTRACT
INTRODUCTION: Infantile hepatic hemangioendothelioma is a type of benign hepatic tumor that occurs in infancy. Many hepatic tumors are diagnosed when screening is done for multiple cutaneous hemangiomas. Hepatic tumors are small multifocal lesions and are mostly asymptomatic. There have been many case reports of asymptomatic infantile hepatic hemangioendothelioma, but few of these have pointed out that hepatic hemangiomas can sometimes be life-threatening due to fatal hepatomegaly complications such as pulmonary artery hypertension or even congestive heart failure. At present, there are no standard protocols for treating infantile hepatic hemangioendothelioma, though most clinicians agree that treatment is unnecessary for multiple small hepatic hemangiomas in asymptomatic patients. Little is known about treatment for cases with life-threatening complications induced by infantile hepatic hemangioendothelioma as there are so few reported cases. Here, we report a special case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency induced by infantile hepatic hemangioendothelioma.
PATIENT CONCERNS: We present a case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency caused by infantile hepatic hemangioendothelioma.
DIAGNOSIS: Infantile hepatic hemangioendothelioma was diagnosed.
INTERVENTIONS: The patient underwent transcatheter arterial embolization and was given propranolol.
OUTCOMES: The patient responded well to treatment with transcatheter arterial embolization and propranolol. The patient gained weight steadily, liver volume, and mass size have decreased considerably, echocardiography showed normal pulmonary artery pressure and ejection fraction, and we discovered no serious complications after 1 year of follow-up.
CONCLUSION: Transcatheter arterial embolization combined with propranolol is an effective treatment for life-threatening infantile hepatic hemangioendothelioma.
PMID:32541524 | PMC:PMC7302649 | DOI:10.1097/MD.0000000000020728
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PubMed articles on: Cardio-Oncology
Resiliency and Our Cardio-Oncology Community
Ky B. JACC CardioOncol 2020.
NO ABSTRACT
PMID:32548596 | PMC:PMC7243765 | DOI:10.1016/j.jaccao.2020.05.003
00:10
PubMed articles on: Cancer & VTE/PE
Real world data regarding the management of cancer-associated thrombosis
Tsoukalas N, et al. Curr Opin Oncol 2020.
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