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Review
. 2021 May 28;7(1):20.
doi: 10.1186/s40959-021-00105-y.

Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer

Renske Altena  1   2 , Laila Hubbert  3 , Narsis A Kiani  4 , Yvonne Wengström  5 , Jonas Bergh  4   6 , Elham Hedayati  4   6
Affiliations
Review

Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer

Renske Altena et al. Cardiooncology. .

Abstract

Background: Cancer treatment-related morbidity relevantly compromises health status in cancer survivors, and efforts to optimise health-related outcomes in this population are vital to maximising healthy survivorship. A pre-treatment assessment - and possibly preventive management strategies - of cancer patients at increased risk for cardiovascular disease (CVD) seems a rational approach in this regard. Definitive evidence for such strategies is largely lacking, thereby impeding the formulation of firm recommendations.

Results: The current scoping review aims to summarise and grade the evidence regarding strategies for prediction and prevention of CVD in adults in relation to oncological treatments. We conducted a scoping literature search for different strategies for primary prevention, such as medical and lifestyle interventions, as well as the use of predictive risk scores. We identified studies with moderate to good strength and up to now limited evidence to recommend primary preventive strategies in unselected patients treated with potentially cardiotoxic oncologic therapies.

Conclusion: Efforts to minimize the CVD burden in cancer survivors are needed to accomplish healthy survivorship. This can be done by means of robust models predictive for CVD events or application of interventions during or after oncological treatments. Up to now there is insufficient evidence to implement preventive strategies in an unselected group of patients treated with potential cardiotoxic oncological treatments. We conclude that randomised controlled trials are needed that evaluate medical and lifestyle interventions in groups at increased risk for complications, in order to be able to influence chronic illness risks, such as cardiovascular complications, for cancer survivors.

Keywords: Cancer survivor; Cardiotoxicity; Evidence-based; Exercise; Lifestyle; Prevention.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
Timing of development of cancer treatment-related cardiovascular disease and time-points for primary prevention. Hypothetical schematic representation of the risk for development of CVD in people treated for malignancy! Adapted from Altena et al., Lancet Oncology 2009 [14]
Fig. 2
Fig. 2
PRISMA flow-chart included trials. a Predictive models. b Primary prevention with medication
See this image and copyright information in PMC

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