Cardiovascular risk factors among cancer patients
qualified for systemic treatment. Analysis
of a cardiovascular disease-free cohort from the Polish
multicentre study ONCOECHO

Nowakowska, Marta; Płońska‐Gościniak, Edyta; Szyszka, Andrzej; Chrzanowski, Łukasz; Krakowska, Magdalena; Potemski, Piotr; Mizia-Stec, Katarzyna; Gąsior, Zbigniew; Bodys, Artur; Siński, Maciej; Gościńska-Szmagała, Adrianna; Gościniak, Piotr; Różewicz, Monika; Zaborska, Beata; Braksator, Wojciech; Kosior, Dariusz A.; Kasprzak, Jarosław D.

doi:10.5114/aoms.2020.100401

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…The compared groups of hematological patients receiving cardiology consultations proved to be quite homogeneous. We observed slightly fewer risk factors for cardiovascular events as compared to those reported in the literature, which may be due to the relatively younger age of the studied patients [ 22 , 23 ]. In the 651 consulted patients, cardiac complications due to hemato-oncological therapy were identified in 57 patients, of which most were mild.…”

Section: Discussioncontrasting

confidence: 67%

The Impact of the COVID-19 Pandemic on the Organization of Cardio-Hematology Care—A Polish Single Center Experience

et al. 2022

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Background and Objectives: We present a retrospective report on the cardio-hematological care of hematology patients at a university hospital in Poland during the COVID-19 pandemic. Materials and Methods: The number of hospitalizations at the Hematology Department and cardio-hematology consultations throughout 2019 and 2020 was analyzed. The types of cardiac procedures, risk factors, and complications were also assessed. Results: A significant reduction in the number of hospitalizations was observed in 2020 as compared to 2019. However, there were no significant differences in the incidence of hematological diseases between both of the analyzed years. In 2019, 299 cardiac consultations were performed in hematological patients, and there was a total of 352 such consultations performed in 2020 (p = 0.042). Less high-risk tests (transesophageal and stress echocardiography) were performed in 2020, in favor of the use of cardiac computed tomography in cardiac diagnostics as it was safer during the pandemic. At least one cardiovascular risk factor during cardiac consultation was noted in 42% and 48% of hematological patients in 2019 and 2020, respectively. Among 651 examined hematological patients, the most common findings were mild cardiac complications of hemato-oncological treatment, which were found in 57 patients. Conclusions: This study seems to confirm that during a pandemic there is an increased demand for well-organized cardio-hematology consultations.

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Section: Discussioncontrasting

confidence: 67%

The Impact of the COVID-19 Pandemic on the Organization of Cardio-Hematology Care—A Polish Single Center Experience

et al. 2022

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“…In a Polish study, it was found that cancer patients were more likely to be smokers, hypertensives, and diabetics than the general population. 34 In this cohort study, 743 CRC patients had hypertension history. In the multivariable regression analysis, CRC patients with prior hypertension history had 1.6 times higher risk of cardiotoxicity than nonhypertensives, a finding that was similar to that found in a previous study.…”

Section: Discussionmentioning

confidence: 96%

Pre-existing chronic kidney disease and hypertension increased the risk of cardiotoxicity among colorectal cancer patients treated with anticancer drugs

Wen

et al. 2021

Journal of the Chinese Medical Association

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Background: This population-based study was to investigate the potential risk factors of cardiotoxicity among colorectal cancer (CRC) patients treated with anticancer drugs. Methods: This was a retrospective cohort study using the National Health Insurance Research Database to identify the CRC patients receiving chemotherapy (CT) alone or CT combined with targeted therapies between 2000 and 2013. The patients enrolled were those who had the first diagnosis of CRC established ≥20 years and had no cancer history three years before the incident diagnosis of CRC. The outcomes of cardiotoxicity were defined by the diagnosis of acute myocarditis, cardiomyopathy, heart failure, hypertensive heart disease, and so on. Results: A total of 11 819 CRC patients were identified and 3781 were eligible; 556 (14.7%) patients developed cardiotoxicity after receiving anticancer treatment. Patients showed a similar risk of having primary outcome (hazard ratio [HR], 0.7; p = 0.3662) between CT and CT combined with targeted therapy groups, whereas the risk of developing secondary outcome was significantly different between the two groups (HR, 0.7; p = 0.0339). The hazard was found to be increased with age (60–69, HR 2.1, p = 0.0236; 70–79, HR 3.3, p = 0.0003; and ≥80, HR 3.7, p < 0.0001). CRC patients who had a prior history of hypertension exhibited a higher risk than those without hypertension (HR 1.6, p < 0.0001). The hazard of having cardiotoxicity among patients with a prior history of severe chronic kidney disease was 2.4 times than that in those without renal dysfunction, regardless of the stage of cancer (HR 2.4, p < 0.0001). Conclusion: CRC patients over 60 years of age run a higher risk of developing cardiotoxicity when treated with anticancer drugs. For CRC patients who have a previous history of hypertension or chronic kidney disease, physicians must be careful in evaluating the risk of anticancer drugs–related cardiotoxicity. Prescribe drugs may prevent cardiotoxicity if necessary.

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“…There has been an association between pre‐existent CV disease and an increased risk of cardiotoxicity in patients treated with chemotherapy 24 . Cancer patients may also have an increased prevalence of significant CV risk factors indicating the need for closer cardiac monitoring during their anti‐cancer treatment 25 . However, the relationship between traditional CV risk factors and ICI use on the subsequent development of CVT could not be comprehensively assessed from our cohort due to the lack of reporting of CV risk factors.…”

Section: Discussionmentioning

confidence: 99%

Incidence of immune checkpoint inhibitor mediated cardiovascular toxicity: A systematic review and meta‐analysis

Malaty

Amarasekera

et al. 2022

Eur J Clin Investigation

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Background Immune checkpoint inhibitors (ICI) are a novel class of anti‐cancer therapy becoming increasingly associated with fatal cardiovascular toxicities (CVTs). The aim is to determine the incidence of CVTs in cohorts treated with ICIs as sole anti‐cancer therapy. Methods A systematic literature search of scientific and medical databases was performed using PRISMA principles to identify relevant cohorts (PROSPERO registration CRD42021272470). Data for specific CVTs (pericardial disease, myocarditis, heart failure, arrhythmia, myocardial infarction/ischaemia and angina), CVT‐related death and CV risk factors were extracted. Presence of CVTs in ICI‐monotherapy versus combination‐ICI therapy, and programmed death 1/programmed death ligand 1‐ (PD1/PDL1‐) versus cytotoxic T‐lymphocyte‐associated protein 4‐ (CTLA4‐) inhibitor groups were dichotomised and meta‐analysed using random‐effect models. Results Forty‐eight studies (11,207 patients) were identified, from which 146 CVTs were observed (incidence 1.30%). ICI‐monotherapy led to more CVTs than combination therapy (119/9009; 1.32% vs. 18/2086; 0.86%). Across monotherapies, PD1/PDL1‐inhibitors had lower incidence of CVTs compared to CTLA4‐inhibitors (62/6950; 0.89% vs. 57/2059; 2.77%). Based on eight studies that were meta‐analysed, no significant difference was observed comparing monotherapy versus combination‐ICI therapy (RR‐0.69, 95% CI −1.47 to 0.09) for all CVTs, or PD1/PDL1‐ to CTLA4‐inhibitors (RR‐0.27, 95% CI −2.06 to 1.53), for all CVTs including CVT‐death. CV risk factors could not be attributed to an ICI group as data was population based rather than individual based. Conclusion ICI‐mediated CVTs are rare and potentially fatal. The role of CV risk factors in their development remains unclear.

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Cardiovascular risk factors among cancer patients qualified for systemic treatment. Analysis of a cardiovascular disease-free cohort from the Polish multicentre study ONCOECHO

Cited by 4 publications

References 21 publications

The Impact of the COVID-19 Pandemic on the Organization of Cardio-Hematology Care—A Polish Single Center Experience

The Impact of the COVID-19 Pandemic on the Organization of Cardio-Hematology Care—A Polish Single Center Experience

Pre-existing chronic kidney disease and hypertension increased the risk of cardiotoxicity among colorectal cancer patients treated with anticancer drugs

Incidence of immune checkpoint inhibitor mediated cardiovascular toxicity: A systematic review and meta‐analysis

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