CARDIOTOXICITY OF ANTICANCER THERAPIES: FOCUS ON THE ROLE OF THE CARDIO-ONCOLOGICAL TEAM. A PRACTICAL REVIEW
GABRIELA SILVIA GHEORGHE 1,2, ANA CIOBANU 1,2*, ANDREEA SIMONA HODOROGEA 1,2, ANDREI CRISTIAN DAN GHEORGHE 1,2, RĂZVAN VALENTIN SCĂUNAȘU 1,3, IOAN TIBERIU NANEA 1,2, MARINELA IONELA STOIAN 1,4, ADRIANA MIHAELA ILIESIU 1,2
1Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2Department of Internal Medicine and Cardiology, “Theodor Burghele” Clinical Hospital, Bucharest, Romania
3Department of General Surgery, Colțea Clinical Hospital, Bucharest, Romania
4Department of Cardiology, University and Emergency Hospital, 169 Splaiul Independenței, 050098, Bucharest, Romania
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In the last decades there were important improvements in oncological therapies which increased the survival of patients. However, patients and doctors are confronted with the side effects of the oncological therapy especially at the level of cardiovascular system. The occurrence of the deleterious effects depends on the class of chemotherapy used and on the history of cardiac risk factors of the patients. Anthracyclines have the highest dose dependent cardiac toxicity and induce acute or longterm heart failure but fluoropyrimidines, cytokines, checkpoint inhibitors can induce myocardial ischemia, arrhythmia, pericardial effusion, vasculitis. Patients should be monitored by a cardio-oncological team. The cardio-vascular protection may be achieved by treating oncological patients who present a high cardiac risk with angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), beta blockers, and statins. The oncologist must select the class of medication that offers the best risk-benefit ratio and must sometimes decide alongside the cardiologist to temporary stop chemotherapy
