Jacc: Cardiooncology最新文献

{"title":"Identifying Patients With Prostate Cancer Who Benefit Most From Routine Cardiovascular Specialist Referral.","authors":"Cristina Cano Garcia, Jehonathan Pinthus, Alvaro Avezum, P J Devereaux, Laurence Klotz, Celestia Higano, Vincent Fradet, Joseph Selvanayagam, Avirup Guha, Ludhmila Hajjar, Jose Patricio Lopez-Lopez, Denis Xavier, Kelvin Ng, Sumathy Rangarajan, Sarah Karampatos, Steven Agapay, Rajibul Mian, Kumar Balasubramanian, Filipe Cirne, Melissa Huynh, Margot K Davis, Robert J Hamilton, Darin Gopaul, Som D Mukherjee, Malik Farooqi, Alexander P Benz, Rachel Richard, Chieh Yang Christopher Koo, Darryl P Leong","doi":"10.1016/j.jaccao.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.jaccao.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>RADICAL PC-2 (RAndomizeD Intervention for CArdiovascular and Lifestyle Risk Factors in Prostate Cancer Patients) was a pragmatic randomized controlled trial that tested whether routine referral to a cardiologist or an internist for cardiovascular (CV) risk-factor and lifestyle modification improves outcomes in patients with prostate cancer or receiving androgen-deprivation therapy. The intervention group had more favorable outcomes overall, driven by improved cholesterol control, with no differences in rates of CV death, myocardial infarction (MI), stroke, or heart failure (HF).</p><p><strong>Objectives: </strong>The authors aim to identify patient subgroups more likely to benefit from routine CV care referral.</p><p><strong>Methods: </strong>Prespecified subgroup analyses were used to assess whether patients at higher CV risk derived greater benefit from specialist referral, with treatment-effect heterogeneity assessed using interaction tests. The first primary outcome was a hierarchical composite of CV death, MI, stroke, HF, suboptimal cholesterol, and systolic blood pressure (SBP) control, evaluated using the win ratio. The second primary outcome was time to CV death, MI, stroke, or HF.</p><p><strong>Results: </strong>Among 2487 participants, treatment effect differed by baseline total cholesterol ≤4 mmol/L vs >4 mmol/L (interaction P = 0.016), with respective win ratios of 1.21 (95% CI: 0.89-1.64) and 1.75 (95% CI: 1.51-2.03), and by baseline BP status (SBP ≥130 mm Hg or diastolic BP ≥80 mm Hg vs BP <130/80 mm Hg; interaction P = 0.003), with respective subdistribution HRs (sHRs) for CV death, MI, stroke, or HF of 0.86 (95% CI: 0.61-1.21) and 4.85 (95% CI: 1.65-14.26). The interaction for diabetes did not reach statistical significance (interaction P = 0.054) although the intervention effect estimates suggested a potential difference by diabetes status, with sHRs of 0.53 (95% CI: 0.24-1.15) among participants with diabetes and 1.25 (95% CI: 0.88-1.78) among participants without diabetes. The win ratio was higher among participants with total cholesterol >4 mmol/L, and sHRs were numerically lower among those with SBP ≥130 mm Hg or diastolic BP ≥80 mm Hg and diabetes.</p><p><strong>Conclusions: </strong>Uncontrolled modifiable CV risk factors may identify patients with prostate cancer who are more likely to benefit from routine CV care referral.</p>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":15.5,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical Remission and Residual Cardiac Abnormalities in AL Amyloidosis.","authors":"Jiaxin Cai","doi":"10.1016/j.jaccao.2026.05.013","DOIUrl":"https://doi.org/10.1016/j.jaccao.2026.05.013","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":15.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin Decline and Occult Cancer After OAC Initiation","authors":"Joong Min Lee MD,&nbsp;Min Soo Cho MD, PhD,&nbsp;Duk-Woo Park MD, PhD","doi":"10.1016/j.jaccao.2026.07.004","DOIUrl":"10.1016/j.jaccao.2026.07.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 392-394"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148770021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Platelets Explain Why GnRH Antagonists Are Potentially Safer From a Cardiovascular Perspective?","authors":"Ye Deng MD,&nbsp;Yan Wang MD, PhD,&nbsp;Leilei Cheng MD, PhD","doi":"10.1016/j.jaccao.2026.07.003","DOIUrl":"10.1016/j.jaccao.2026.07.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 428-430"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining the Prognostic Interpretation of Myocardial PD-L1 Expression in ICI-Associated Myocarditis","authors":"Shangxuan Li MM,&nbsp;Yi Wang PhD,&nbsp;Zekai Yu MS,&nbsp;Lu Yin MM,&nbsp;Dianyuan Li PhD","doi":"10.1016/j.jaccao.2026.04.010","DOIUrl":"10.1016/j.jaccao.2026.04.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Page 446"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacubitril/Valsartan in Anthracycline-Treated Patients","authors":"Luigi Spadafora MD, MSc,&nbsp;Massimiliano Camilli MD, PhD","doi":"10.1016/j.jaccao.2026.04.001","DOIUrl":"10.1016/j.jaccao.2026.04.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 431-433"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When “Uptake” Is Organelle Biology","authors":"Lukasz Szarpak MD, PhD,&nbsp;Michal Pruc MD, PhD,&nbsp;Andrea Denegri MD, PhD","doi":"10.1016/j.jaccao.2026.03.009","DOIUrl":"10.1016/j.jaccao.2026.03.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Page 448"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple Clinical Risk Score to Improve Prediction of Anthracycline-Induced Cardiotoxicity","authors":"Daniela Cardinale MD, PhD,&nbsp;Nicola Cosentino MD, PhD,&nbsp;Chiara Morocutti MSc,&nbsp;Luisa Quaggiotti MD,&nbsp;Valeria Marenzi MD,&nbsp;Jesús Saldaña-García MD,&nbsp;Teresa López-Fernández MD,&nbsp;Luca Piacentini MSc,&nbsp;Alice Bonomi PhD,&nbsp;Giancarlo Marenzi MD","doi":"10.1016/j.jaccao.2026.06.005","DOIUrl":"10.1016/j.jaccao.2026.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Anthracycline-induced cardiotoxicity is a major limitation of cancer therapy, highlighting the need for accurate and practical risk stratification. Although current guidelines recommend the Heart Failure Association–International Cardio-Oncology Society (HFA-ICOS) score for baseline risk assessment, its complexity may limit routine clinical use.</div></div><div><h3>Objectives</h3><div>This study sought to develop and validate a simplified risk score based on readily available clinical and echocardiographic variables for predicting anthracycline-related cardiotoxicity, and to compare its performance with the HFA-ICOS model.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 2,612 adult cancer patients with baseline left ventricular ejection fraction (LVEF) of ≥50% treated with anthracyclines. Echocardiography was performed at baseline, during therapy, and up to 2 years after treatment. Cardiotoxicity was defined as a decrease in LVEF of &gt;10 percentage points to a value &lt;50% or the development of heart failure. The predictive performance of the HFA-ICOS score was assessed using the area under the receiver operating characteristic curve (AUC). A simplified model was derived using logistic regression with cross-validation and was further validated with machine learning techniques. External validation was conducted in an independent cohort of 819 patients.</div></div><div><h3>Results</h3><div>Over the first 2 years, the likelihood of cardiotoxicity was higher in the moderate (HR: 1.44, 95% CI: 1.02-2.06) and high (HR: 1.84, 95%:CI: 1.36-2.50) HFA-ICOS risk categories compared to the low-risk group. The cumulative incidence of cardiotoxicity was 8.3% (95% CI: 7.1%-9.1%) at 12 months, with only 5 additional events observed in patients still at risk through 2 years. The HFA-ICOS score showed good discrimination at 1 year (AUC: 0.76, 95% CI: 0.67-0.86). A simplified model including postchemotherapy LVEF and cumulative anthracycline dose (RE-ACT score) demonstrated higher accuracy at 1 year (AUC: 0.83, 95% CI: 0.74-0.93) though not statistically different. Combining both scores in the derivation cohort further improved predictive performance (AUC: 0.87, 95% CI: 0.80-0.95; <em>P</em> &lt; 0.001 vs HFA-ICOS score). In the validation cohort, the RE-ACT score achieved an AUC of 0.88 (95% CI: 0.80-0.95) at 1 year.</div></div><div><h3>Conclusions</h3><div>HFA-ICOS score effectively stratifies baseline risk, while the RE-ACT score provides additional post-treatment prognostic value. Their integration supports a practical 2-step strategy for personalized surveillance in cardio-oncology.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 364-375"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacubitril/Valsartan and Right Ventricular and Diastolic Function During Breast Cancer Therapy","authors":"Mari Nordbø Gynnild MD, PhD,&nbsp;Albulena Mecinaj Lilleaasen MD,&nbsp;Torgeir Wethal MD, PhD,&nbsp;Even O. Jakobsen MSc,&nbsp;Victoria Vinje-Jakobsen MD,&nbsp;Siri Lagethon Heck MD, PhD,&nbsp;Stian Larsen MD,&nbsp;Assami Rösner MD, PhD,&nbsp;Havard Dalen MD, PhD,&nbsp;Torbjørn Omland MD, PhD,&nbsp;Geeta Gulati MD, PhD,&nbsp;Espen Holte MD, PhD","doi":"10.1016/j.jaccao.2026.06.002","DOIUrl":"10.1016/j.jaccao.2026.06.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 434-436"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular Accident Risk in Survivors of Head and Neck Cancer","authors":"Courtney Pisano DO, MS, MPH,&nbsp;Jenica Upshaw MD,&nbsp;Benjamin Colvard MD,&nbsp;David Zidar MD, PhD,&nbsp;Ryan Hughes MD,&nbsp;Karem Harth MD,&nbsp;Sahil Parikh MD,&nbsp;Theodore Arsenault PhD,&nbsp;Kamal Chemali MD,&nbsp;Natalie Evans MD,&nbsp;Matthew Mirsky MD,&nbsp;Eli Scher MD,&nbsp;Christopher Murphy MSN, CNP,&nbsp;Logan Cho MD,&nbsp;Jennifer Dorth MD, MHSc","doi":"10.1016/j.jaccao.2026.06.003","DOIUrl":"10.1016/j.jaccao.2026.06.003","url":null,"abstract":"<div><div>Head and neck cancer survivors treated with radiation therapy have a substantially higher long-term risk of cerebrovascular accident than the general population, driven by radiation-related carotid artery injury, baseline cardiovascular risk factors, and the effects of chemotherapy. Carotid stenosis progresses over time, making regular ultrasound screening important for early detection and intervention. Statin therapy during and after radiation therapy, along with intensive blood pressure management, may reduce cerebrovascular event rates. Guidelines increasingly recommend integrating cardiovascular risk assessment and prevention into cancer care, with special consideration of radiation- and chemotherapy-related risk and aggressive risk factor modification. Multidisciplinary strategies, including medication, lifestyle interventions, and timely revascularization for progressive or symptomatic carotid stenosis, are essential to improve outcomes and minimize cerebrovascular accident risk in head and neck cancer survivors.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"8 4","pages":"Pages 339-356"},"PeriodicalIF":15.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}