Cardiovascular complications of cancer therapy: diagnosis, pathogenesis, and management

Circulation. 2004 Jun 29;109(25):3122-31. doi: 10.1161/01.CIR.0000133187.74800.B9.

Abstract

The cardiotoxicity of anticancer agents can lead to significant complications that can affect patients being treated for various malignancies. The severity of such toxicity depends on many factors such as the molecular site of action, the immediate and cumulative dose, the method of administration, the presence of any underlying cardiac condition, and the demographics of the patient. Moreover, toxicity can be affected by current or previous treatment with other antineoplastic agents. Cardiotoxic effects can occur immediately during administration of the drug, or they may not manifest themselves until months or years after the patient has been treated. In this article we review commonly used chemotherapy agents, including several recently approved medications, for their propensity to cause cardiotoxicity. Further research will be required to more accurately predict which patients are at risk for developing cardiotoxicity. In addition, management plans, as well as strategies to reduce cardiotoxicity, need to be developed.

Publication types

  • Review

MeSH terms

  • Anthracyclines / adverse effects
  • Anthracyclines / therapeutic use
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Antimetabolites, Antineoplastic / adverse effects
  • Antimetabolites, Antineoplastic / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / classification
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Biomarkers
  • Biopsy
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / prevention & control
  • Cardiovascular Diseases / therapy
  • Cytokines / adverse effects
  • Cytokines / therapeutic use
  • Heart / radiation effects
  • Humans
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Neoplasms / radiotherapy
  • Pericardium / radiation effects
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects*
  • Razoxane / therapeutic use
  • Risk Factors

Substances

  • Anthracyclines
  • Antibodies, Monoclonal
  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • Antineoplastic Agents, Alkylating
  • Biomarkers
  • Cytokines
  • Razoxane