Chemotherapy-induced cardiotoxicity: detection, prevention, and management

Can J Cardiol. 2014 Aug;30(8):869-78. doi: 10.1016/j.cjca.2014.04.029. Epub 2014 May 4.

Abstract

Chemotherapy-induced cardiotoxicity is a major cause of morbidity and mortality in cancer survivors. It might manifest as arrhythmia, hypertension, myocardial ischemia, thromboembolism, heart failure, systolic dysfunction, or other adverse events. Anthracyclines and trastuzumab are the chemotherapeutic agents with the most documented cardiac side effects; however, the array of novel molecular targeting therapies available is concerning because their side effects are not yet well understood. Nevertheless, there are potential strategies to mitigate the risks of cardiac complications for cancer patients. In this article, the common systemic drugs with cardiotoxic potential and the monitoring and diagnostic tools, including the role of biomarkers for early detection, are reviewed. We will also review the use of cardioprotectant agents as pharmacological interventions in prophylactic and treatment settings. Our aim is to provide a concise and up-to-date summary of the detection, management, and prevention of chemotherapy-induced cardiotoxicity for the busy clinician.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Cardiotonic Agents / therapeutic use
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / prevention & control*
  • Drug Monitoring
  • Echocardiography
  • Electrocardiography
  • Humans
  • Medical History Taking
  • Neoplasms / drug therapy
  • Risk Factors
  • Stroke Volume

Substances

  • Antineoplastic Agents
  • Cardiotonic Agents