Jacc: Cardiooncology最新文献

{"title":"SGLT2i Therapy Prevents Anthracycline-Induced Cardiotoxicity in a Large Animal Model by Preserving Myocardial Energetics","authors":"Danielle Medina-Hernández MSc ,&nbsp;Laura Cádiz PhD ,&nbsp;Annalaura Mastrangelo PhD ,&nbsp;Andrea Moreno-Arciniegas MD ,&nbsp;Miguel Fernández Tocino MSc ,&nbsp;Alejandro A. Cueto Becerra MSc ,&nbsp;Anabel Díaz-Guerra Priego MSc ,&nbsp;Warren A. Skoza MD ,&nbsp;María Isabel Higuero-Verdejo DVM ,&nbsp;Gonzalo Javier López-Martín Tech ,&nbsp;Claudia Pérez-Martínez PhD ,&nbsp;Antonio de Molina-Iracheta DVM ,&nbsp;María Caballero-Valderrama MD, PhD ,&nbsp;Javier Sánchez-González PhD ,&nbsp;David Sancho PhD ,&nbsp;Valentin Fuster MD, PhD ,&nbsp;Carlos Galán-Arriola DVM, PhD ,&nbsp;Borja Ibáñez MD, PhD","doi":"10.1016/j.jaccao.2024.12.004","DOIUrl":"10.1016/j.jaccao.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Anthracycline-induced cardiotoxicity (AIC) is characterized by a disruption in myocardial metabolism.</div></div><div><h3>Objectives</h3><div>The authors used a large animal model to test sodium-glucose cotransporter inhibitor therapy to prevent AIC.</div></div><div><h3>Methods</h3><div>Female large white pigs (n = 36) were used to identify the most translational AIC regimen: 6 triweekly intravenous doxorubicin injections (1.8 mg/kg each). Another group of 32 pigs were randomized (1:1:2) to doxorubicin plus empagliflozin 20 mg, doxorubicin plus empagliflozin 10 mg, or doxorubicin control. Pigs were serially examined using multiparametric cardiac magnetic resonance and magnetic resonance spectroscopy. At the end of the 21-week follow-up period, blood samples were obtained to measure myocardial metabolic substrate extraction, and the left ventricle was harvested and processed for analysis using metabolomics, transmission electron microscopy, mitochondrial respirometry, and histopathology.</div></div><div><h3>Results</h3><div>Final left ventricular ejection fraction (LVEF), the prespecified primary outcome, was significantly higher in pigs receiving 20 mg empagliflozin than in the doxorubicin control group (median 57.5% [Q1-Q3: 55.5%-60.3%] vs 47.0% [Q1-Q3: 40.8%-47.8%]; <em>P</em> = 0.027). Final LVEF in pigs receiving 10 mg empagliflozin was 51% (Q1-Q3: 46.5%-55.5%; <em>P</em> = 0.020 vs 20 mg empagliflozin). The incidence of AIC events was 0%, 50%, and 72% in the empagliflozin 20 mg, empagliflozin 10 mg, and doxorubicin control groups, respectively. Empagliflozin 20 mg treatment resulted in enhanced ketone body consumption by the myocardium, preserved magnetic resonance spectroscopy–measured cardiac energetics, and improved mitochondrial structure and function on transmission electron microscopy and respirometry. These changes were more modest with the 10-mg empagliflozin dose.</div></div><div><h3>Conclusions</h3><div>Sodium-glucose cotransporter-2 inhibitor therapy with empagliflozin exerts a dose-dependent cardioprotective effect against AIC. The improved LVEF was accompanied by enhanced ketone body consumption, improved cardiac energetics, and preserved mitochondrial structure and function.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 171-184"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437048","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":"Growth Differentiation Factor-15 Predicts Major Bleeding in Cancer Patients","authors":"Cornelia Englisch MD ,&nbsp;Stephan Nopp MD, MSc ,&nbsp;Florian Moik MD, PhD ,&nbsp;Daniel Steiner MD ,&nbsp;Angelika M. Starzer MD ,&nbsp;Monika Fritzer-Szekeres MD ,&nbsp;Matthias Preusser MD ,&nbsp;Anna S. Berghoff MD, PhD ,&nbsp;Ingrid Pabinger MD ,&nbsp;Cihan Ay MD","doi":"10.1016/j.jaccao.2024.11.007","DOIUrl":"10.1016/j.jaccao.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>The hemostatic system is tightly interconnected with cancer. Research has focused predominantly on thrombotic complications, but less is known about bleeding and bleeding risk prediction. Growth differentiation factor (GDF)-15 has previously emerged as a prognostic biomarker for bleeding.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate the association and predictive ability of GDF-15 for bleeding risk in patients with cancer.</div></div><div><h3>Methods</h3><div>The CAT-BLED (Vienna Cancer, Thrombosis, and Bleeding) study is a prospective, observational cohort study including cancer patients initiating systemic anticancer therapies. Patients were followed for up to 2 years for thrombotic and bleeding events. The primary outcome was major bleeding. GDF-15 was measured at inclusion and at 3 and 6 months of follow-up.</div></div><div><h3>Results</h3><div>A total of 779 patients (48% women, median age 62 years, 15% on therapeutic anticoagulation) were included. During a median follow-up period of 18 months, 79 patients (10.1%) experienced major bleeding (12-month cumulative incidence 8.8%; 95% CI: 6.7-10.9). Higher GDF-15 levels were independently associated with increased major bleeding risk (adjusted subdistribution HR per doubling: 1.29; 95% CI: 1.04-1.59), and patients with levels greater than the cohort median (1,864 ng/L) had a significantly higher 12-month cumulative incidence (13.1% vs 4.6%; <em>P</em> &lt; 0.001). This association remained robust in follow-up measurements at 3 and 6 months. GDF-15 showed moderate to good discrimination for predicting 6-month major bleeding risk (C statistic = 0.69; 95% CI: 0.60-0.77). GDF-15 was not associated with venous thromboembolism but was strongly associated with mortality (adjusted HR: 1.37; 95% CI: 1.25-1.50).</div></div><div><h3>Conclusions</h3><div>GDF-15 levels predict major bleeding risk in cancer patients and are not associated with venous thromboembolism, making GDF-15 a particularly promising biomarker for bleeding risk prediction.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 141-152"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437047","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":"Empagliflozin to Prevent Doxorubicin Cardiotoxicity","authors":"Zhen Guo PhD ,&nbsp;Ali Javaheri MD, PhD","doi":"10.1016/j.jaccao.2025.01.005","DOIUrl":"10.1016/j.jaccao.2025.01.005","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 185-187"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437049","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":"Cardiovascular Safety in Oncology Clinical Trials","authors":"Marc P. Bonaca MD, MPH ,&nbsp;Ninian N. Lang MBChB, PhD ,&nbsp;Alice Chen MD ,&nbsp;Laleh Amiri-Kordestani MD ,&nbsp;Leslie Lipka MD, PhD ,&nbsp;Michal Zwiewka MD ,&nbsp;Colette Strnadova PhD ,&nbsp;Sigrid Klaar MD, PhD ,&nbsp;Susan Dent MD ,&nbsp;Tijana Krnjeta Janicijevic PharmD, PhD ,&nbsp;Joerg Herrmann MD ,&nbsp;Ana Barac MD, PhD ,&nbsp;Rudolf A. de Boer MD ,&nbsp;Anita Deswal MD, MBBS, MPH ,&nbsp;Morten Schou MD ,&nbsp;Tomas G. Neilan MD, MPH ,&nbsp;Peter van der Meer MD ,&nbsp;Javid Moslehi MD ,&nbsp;Lavanya Kondapalli MD ,&nbsp;Bonnie Ky MD, MSCE ,&nbsp;Mark C. Petrie MD","doi":"10.1016/j.jaccao.2024.09.014","DOIUrl":"10.1016/j.jaccao.2024.09.014","url":null,"abstract":"<div><div>The development of novel treatments has improved cancer outcomes but may result in cardiovascular toxicities. Traditional approaches to clinical trial safety evaluation have limitations in their ability to detect signals of cardiovascular risk. Mechanisms to increase power and specificity to clarify cardiovascular safety are required. However, implications include increased costs and slower development. The Cardiovascular Safety Research Consortium facilitated stakeholder discussions with representation from academia, industry, and regulators. A think tank was assembled with the aim of providing recommendations for improved collection and reporting of cardiovascular safety signals in oncology trials. Two working groups were formed. The first focuses on incorporation of consensus definitions of cardiovascular disease into the Common Terminology Criteria for Adverse Events used in oncology trial reporting. The second group considers methods for ascertainment and adjudication of cardiovascular events in cancer trials. The overarching aim of this primer is to improve understanding of the potential cardiovascular toxicities of cancer therapies.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 83-95"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437037","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":"Navigating the Uncharted","authors":"Beina Hui MD,&nbsp;Weibin Hu MD,&nbsp;Yongkai Lu PhD","doi":"10.1016/j.jaccao.2024.11.009","DOIUrl":"10.1016/j.jaccao.2024.11.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Page 188"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437050","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":"Growth Differentiation Factor-15","authors":"Markus S. Anker MD ,&nbsp;Lars Bullinger MD ,&nbsp;Ulrich Keller MD ,&nbsp;Muhammad Shahzeb Khan MD, MSc","doi":"10.1016/j.jaccao.2025.01.001","DOIUrl":"10.1016/j.jaccao.2025.01.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 153-156"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437059","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":"Impact of Pre-Existing Frailty on Cardiotoxicity Among Breast Cancer Patients Receiving Adjuvant Therapy","authors":"Shuang Yang MS ,&nbsp;Xiwei Lou MS ,&nbsp;Mustafa M. Ahmed MD ,&nbsp;Stephen E. Kimmel MD ,&nbsp;Karen C. Daily DO ,&nbsp;Thomas J. George MD ,&nbsp;Carl J. Pepine MD ,&nbsp;Jiang Bian PhD ,&nbsp;Dejana Braithwaite PhD, MSc ,&nbsp;Dongyu Zhang PhD ,&nbsp;Yi Guo PhD","doi":"10.1016/j.jaccao.2024.10.012","DOIUrl":"10.1016/j.jaccao.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Prior research suggests that breast cancer patients with a high burden of frailty may face an increased risk of cardiotoxicity.</div></div><div><h3>Objectives</h3><div>This study sought to examine the association between frailty and cardiotoxicity rates in female breast cancer patients receiving adjuvant therapy after surgery.</div></div><div><h3>Methods</h3><div>We analyzed data from the OneFlorida+ clinical research network, focusing on breast cancer patients treated with adjuvant chemotherapy and targeted therapy from 2012 to 2022. Cardiovascular rates during adjuvant treatments were calculated based on pre-existing frailty, measured using the cumulative deficit frailty index (electronic health record frailty index). We employed multivariable Gray’s method to examine the association between frailty with cardiotoxicity.</div></div><div><h3>Results</h3><div>The final cohort included 2,050 patients (mean age 50.6 years), with 415 (20.2%) experiencing nonfatal adverse cardiovascular events after adjuvant therapy. The incidence of adverse cardiovascular events was 17.8% in robust, 23.2% in prefrail, and 29.4% in frail patients. In multivariable analysis, prefrail (adjusted subdistribution HR [sHR]: 1.35; 95% CI: 1.06-1.71; <em>P</em> = 0.015) and frail (adjusted sHR: 1.70; 95% CI: 1.11-2.61; <em>P</em> = 0.015) patients had a higher likelihood of experiencing adverse cardiovascular events compared with robust patients. Among non-Hispanic White and Black patients, prefrail (adjusted sHR: 1.48; 95% CI: 1.04-2.11; <em>P</em> = 0.031; and adjusted sHR: 1.59; 95% CI: 1.06-2.37; <em>P</em> = 0.024, respectively) and frail (adjusted sHR: 1.96; 95% CI: 1.10-3.50; <em>P</em> = 0.022; and adjusted sHR: 2.13; 95% CI: 1.11-4.10; <em>P</em> = 0.023, respectively) patients were more likely to experience adverse cardiovascular events compared with robust patients. No significant differences were observed in other racial/ethnic groups.</div></div><div><h3>Conclusions</h3><div>These findings highlight the need for close monitoring of cardiotoxicity in frail breast cancer patients undergoing adjuvant treatments to improve cardiovascular risk management.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 110-121"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437054","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":"Frailty","authors":"Mina S. Sedrak MD, MS ,&nbsp;Aarti Asnani MD","doi":"10.1016/j.jaccao.2025.01.004","DOIUrl":"10.1016/j.jaccao.2025.01.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 122-124"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437055","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":"Vascular Complications of Atrial Fibrillation in Patients With Cancer","authors":"Lorenzo Gervaso MD, PhD ,&nbsp;Daniela Cardinale MD, PhD ,&nbsp;Nicola Fazio MD, PhD","doi":"10.1016/j.jaccao.2025.01.003","DOIUrl":"10.1016/j.jaccao.2025.01.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 168-170"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437058","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":"Novel Potential Blood Biomarkers for Detection of Anthracycline-Related Cardiomyopathy in Childhood Cancer Survivors","authors":"Jan M. Leerink MD, PhD ,&nbsp;Elizabeth A.M. Feijen PhD","doi":"10.1016/j.jaccao.2024.11.005","DOIUrl":"10.1016/j.jaccao.2024.11.005","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 1","pages":"Pages 68-69"},"PeriodicalIF":12.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080804","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}