目前,几乎所有抗肿瘤的药物和非药物治疗方法都可直接造成心脏和血管损伤,且恶性肿瘤与心血管疾病常伴有共同的危险因素,故心血管疾病已成为老年肿瘤患者致死的重要原因,严重恶化患者预后。2022年8月26日,在巴塞罗那举行的欧洲心脏病学...目前,几乎所有抗肿瘤的药物和非药物治疗方法都可直接造成心脏和血管损伤,且恶性肿瘤与心血管疾病常伴有共同的危险因素,故心血管疾病已成为老年肿瘤患者致死的重要原因,严重恶化患者预后。2022年8月26日,在巴塞罗那举行的欧洲心脏病学会(European Society of Cardiology,ESC)年会上,首部肿瘤心脏病学指南隆重发布,该指南由ESC联合欧洲血液病协会(European Hematology Association,EHA)。展开更多
There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the c...There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the cardiovascular system can be directly on the heart by altering the coagulability state or by altering the hemodynamic system. Some drugs like Sunitinib and Bevacizumab show Heart Failure which is chemotherapy-induced. Other agents are notorious for showing QT prolongation like Vandetanib. Similarly, other agents with demonstrated cardiotoxicity would be molecular-targeted drugs (Trastuzumab and Pertuzumab) and cytostatic agents (Anthracycline antibiotics, Cyclophosphamide and 5-FU). These effects may present early or late, during or after the treatment. Most of the research has focused on the management and monitoring of patients for cancer who are under treatment, for example new biomarkers in the field of proteomics have been discovered for the diagnosis, treatment, and monitoring of patients. While the upgrades have been successful in reducing mortalities, with the advent of better treatment outcomes, the several adverse effects on the cardiac system cannot be dismissed. For instance, damage to the cardiomyocytes is most frequently associated with the treatment. The damage can further expedite LV failure, valvular dysfunction, conduction abnormalities, etc. Hence, a better management plan for patients with cancer would be one that not only caters to primary cancer treatment but also incorporates ventricular systolic function evaluation using echocardiography, electrocardiography, and cardiac biomarkers for the well-being of patients. Our article focuses on introducing an ideal cardio-oncology team along with the components required for setting up the team. This needs a multidisciplinary approach to reduce patients’ cardiovascular morbidity, during and after the interventions. With the growing population of patients undergoing cancer therapy, the risk of developing cardiovascular problems has furt展开更多
BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer(CRC).Cardiovascular disease(CVD)-specific mortality is the second-most frequent cause of death.The ri...BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer(CRC).Cardiovascular disease(CVD)-specific mortality is the second-most frequent cause of death.The risk factors for CVDspecific mortality among older patients with CRC are still poorly understood.AIM To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.METHODS The data on older patients diagnosed with CRC were retrieved from The Surveillance,Epidemiology,and End Results database from 2004 to 2015.The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.RESULTS A total of 141251 eligible patients with CRC were enrolled,of which 41459 patients died of CRC and 12651 patients died of CVD.The age at diagnosis,sex,marital status,year of diagnosis,surgery,and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC.We used these variables to develop a model to predict CVD-specific mortality.The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations.The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734,respectively.CONCLUSION The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC.This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.展开更多
文摘目前,几乎所有抗肿瘤的药物和非药物治疗方法都可直接造成心脏和血管损伤,且恶性肿瘤与心血管疾病常伴有共同的危险因素,故心血管疾病已成为老年肿瘤患者致死的重要原因,严重恶化患者预后。2022年8月26日,在巴塞罗那举行的欧洲心脏病学会(European Society of Cardiology,ESC)年会上,首部肿瘤心脏病学指南隆重发布,该指南由ESC联合欧洲血液病协会(European Hematology Association,EHA)。
文摘There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the cardiovascular system can be directly on the heart by altering the coagulability state or by altering the hemodynamic system. Some drugs like Sunitinib and Bevacizumab show Heart Failure which is chemotherapy-induced. Other agents are notorious for showing QT prolongation like Vandetanib. Similarly, other agents with demonstrated cardiotoxicity would be molecular-targeted drugs (Trastuzumab and Pertuzumab) and cytostatic agents (Anthracycline antibiotics, Cyclophosphamide and 5-FU). These effects may present early or late, during or after the treatment. Most of the research has focused on the management and monitoring of patients for cancer who are under treatment, for example new biomarkers in the field of proteomics have been discovered for the diagnosis, treatment, and monitoring of patients. While the upgrades have been successful in reducing mortalities, with the advent of better treatment outcomes, the several adverse effects on the cardiac system cannot be dismissed. For instance, damage to the cardiomyocytes is most frequently associated with the treatment. The damage can further expedite LV failure, valvular dysfunction, conduction abnormalities, etc. Hence, a better management plan for patients with cancer would be one that not only caters to primary cancer treatment but also incorporates ventricular systolic function evaluation using echocardiography, electrocardiography, and cardiac biomarkers for the well-being of patients. Our article focuses on introducing an ideal cardio-oncology team along with the components required for setting up the team. This needs a multidisciplinary approach to reduce patients’ cardiovascular morbidity, during and after the interventions. With the growing population of patients undergoing cancer therapy, the risk of developing cardiovascular problems has furt
基金Supported by the Youth Project of Natural Science Foundation of Shandong Province,No.ZR2022QH346.
文摘BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer(CRC).Cardiovascular disease(CVD)-specific mortality is the second-most frequent cause of death.The risk factors for CVDspecific mortality among older patients with CRC are still poorly understood.AIM To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.METHODS The data on older patients diagnosed with CRC were retrieved from The Surveillance,Epidemiology,and End Results database from 2004 to 2015.The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.RESULTS A total of 141251 eligible patients with CRC were enrolled,of which 41459 patients died of CRC and 12651 patients died of CVD.The age at diagnosis,sex,marital status,year of diagnosis,surgery,and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC.We used these variables to develop a model to predict CVD-specific mortality.The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations.The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734,respectively.CONCLUSION The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC.This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.
