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J Am Coll Cardiol, 2009; 53:2231-2247, doi:10.1016/j.jacc.2009.02.050
© 2009 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

Cardiovascular Complications of Cancer Therapy

Incidence, Pathogenesis, Diagnosis, and Management

Edward T.H. Yeh, MD*,{ddagger},* and Courtney L. Bickford, PharmD, BCPS{dagger}

* Department of Cardiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
{dagger} Division of Pharmacy, University of Texas M. D. Anderson Cancer Center, Houston, Texas
{ddagger} Texas Heart Institute/St. Luke's Episcopal Hospital, Houston, Texas

Manuscript received August 7, 2008; revised manuscript received January 27, 2009, accepted February 6, 2009.

* Reprint requests and correspondence: Dr. Edward T. H. Yeh, The University of Texas M. D. Anderson Cancer Center, Department of Cardiology, 1400 Pressler Street, Room 11.5028, Houston, Texas 77030 (Email: etyeh{at}mdanderson.org).

Cancer treatment today employs a combination of chemotherapy, radiotherapy, and surgery to prolong life and provide cure. However, many of these treatments can cause cardiovascular complications such as heart failure, myocardial ischemia/infarction, hypertension, thromboembolism, and arrhythmias. In this article we review the incidence of cardiotoxicity caused by commonly used chemotherapeutic agents as well as discuss the pathogenesis, diagnosis, management, and prevention of these cardiovascular side effects. Cardiotoxicity related to anticancer treatment is important to recognize as it may have a significant impact on the overall prognosis and survival of cancer patients, and it is likely to remain a significant challenge for both cardiologists and oncologists in the future due to an increasing aging population of patients with cancer and the introduction of many new cancer therapies.

Key Words: cancer • cardiotoxicity • therapy • heart failure

Abbreviations and Acronyms
  ACE = angiotensin-converting enzyme
  ACS = acute coronary syndrome
  ATE = arterial thrombotic event
  ATP = adenosine triphosphate
  CMP = cardiomyopathy
  CTCL = cutaneous T-cell lymphoma
  DVT = deep vein thrombosis
  FDA = Food and Drug Administration
  HF = heart failure
  HTN = hypertension
  LMWH = low-molecular-weight heparin
  LVD = left ventricular dysfunction
  LVEF = left ventricular ejection fraction
  MI = myocardial infarction
  MUGA = multigated acquisition scan
  PE = pulmonary embolism
  VEGF = vascular endothelial growth factor
  VTE = venous thromboembolism
  5-FU = 5-fluorouracil


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J. Am. Coll. Cardiol. 2009 53: A26. [Full Text] [PDF]



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