Advances in Cardioprotection Strategies: Focusing on Breast Cancer and Beyond Through Novel Biomarkers and Pharmacological Approaches.

Abstract

Recent improvements in cancer treatments have significantly improved patient survival rates, which has drawn attention to cardiovascular complications that may arise after using oncological therapies. These complications can seriously affect quality of life and long-term outcomes, sometimes leading to the need for modification or discontinuation of cancer treatment. This highlights the urgent need for effective cardioprotective strategies to prevent and mitigate clinical and subclinical cardiotoxicity, as well as reducing acute and chronic cardiac damage. In this review, we critically evaluate the cardiac biomarkers used in clinical practice for early detection and monitoring of cardiotoxicity, focusing on N-terminal pro-B-type natriuretic peptide and troponins due to their established predictive value. We also explore emerging biomarkers that may improve cardiovascular risk assessment in cancer patients. On the pharmacological front, β-blockers, angiotensin-converting enzyme inhibitors and sodium-glucose cotransporter 2 inhibitors show potential for mitigating cardiotoxicity, although evidence from randomised trials remains mixed. Non-pharmacological approaches are also discussed, and the aim is to integrate comprehensive cardiovascular prevention into oncology care.