Abdelrahman Ali MD , Efstratios Koutroumpakis MD , Juhee Song PhD , Daniel Booser MD , Carlos H. Barcenas MD, MSc , Debu Tripathy MD , Ana Barac MD, PhD , Nicolas L. Palaskas MD, MPH , Anita Deswal MD, MPH
{"title":"Risk Stratification for Trastuzumab-Induced Cardiac Dysfunction and Potential Implications for Surveillance","authors":"Abdelrahman Ali MD , Efstratios Koutroumpakis MD , Juhee Song PhD , Daniel Booser MD , Carlos H. Barcenas MD, MSc , Debu Tripathy MD , Ana Barac MD, PhD , Nicolas L. Palaskas MD, MPH , Anita Deswal MD, MPH","doi":"10.1016/j.jaccao.2024.12.007","DOIUrl":"10.1016/j.jaccao.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Although patient factors and sequential anthracycline use contribute to risk for cancer therapy–related cardiac dysfunction (CTRCD) with HER2-directed cancer therapy, frequent (every 3 months) left ventricular ejection fraction (LVEF) surveillance is recommended irrespective of baseline risk.</div></div><div><h3>Objectives</h3><div>The aim of this study was to examine the incidence of trastuzumab-associated CTRCD in a contemporary cohort with HER2-positive breast cancer and assess the performance of a risk assessment tool to identify patients at low risk for CTRCD to guide risk-based surveillance strategies.</div></div><div><h3>Methods</h3><div>A retrospective cohort of patients with HER2-positive breast cancer treated with trastuzumab at a tertiary cancer center was examined. Patients were categorized as low, medium, and high or very high risk for CTRCD by Heart Failure Association/International Cardio-Oncology Society risk assessment.</div></div><div><h3>Results</h3><div>Of 496 patients treated with trastuzumab, 29.8% also received anthracyclines. Over a median follow-up period of 51 months, 8.7% developed CTRCD, but only 1.6% had associated heart failure (HF). CTRCD rates were 3.6%, 12.8%, and 32.1% in low-risk, medium-risk, and high or very high risk groups, respectively. HF incidence was 0.4% in the low-risk group and 2.1% in the medium-risk group, with no HF in patients at low- or medium-risk who received trastuzumab without anthracyclines. HF was observed in 11% of high-risk patients. The risk assessment had a negative predictive value for CTRCD in low vs moderate- or high-risk patients of 96.4% (95% CI: 93.5%-98.3%).</div></div><div><h3>Conclusions</h3><div>The findings support the exploration of a prospective personalized risk-based approach to cardiac LVEF surveillance during trastuzumab therapy. Less frequent LVEF monitoring in low-risk patients may optimize resource use and reduce patient burden without compromising safety.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 203-215"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834993","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}
Rebecca Cunningham MD, PhD , Sang Gune K. Yoo MD , Alexander A. Brescia MD, MSc , Karolyn A. Oetjen MD, PhD , Iskra Pusic MD, MSCI , Joshua D. Mitchell MD, MSCI
{"title":"Severe Aortic Stenosis and Chronic Myeloid Leukemia","authors":"Rebecca Cunningham MD, PhD , Sang Gune K. Yoo MD , Alexander A. Brescia MD, MSc , Karolyn A. Oetjen MD, PhD , Iskra Pusic MD, MSCI , Joshua D. Mitchell MD, MSCI","doi":"10.1016/j.jaccao.2025.01.010","DOIUrl":"10.1016/j.jaccao.2025.01.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 305-308"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835005","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}
Aaron Ackerman MD , Daniel Ly MD , Monica Hall MD , Mohamed S. Dabour MS , Nathan Rodgers MD, MHA , Shanti Narasimhan MBBS , Mahmoud Elsherif BSc , Beshay N. Zordoky BSc, MSc, PhD , Karim T. Sadak MD, MPH, MSE
{"title":"Long-Term Care of Childhood Cancer Survivors at Risk for Cardiac Late Effects","authors":"Aaron Ackerman MD , Daniel Ly MD , Monica Hall MD , Mohamed S. Dabour MS , Nathan Rodgers MD, MHA , Shanti Narasimhan MBBS , Mahmoud Elsherif BSc , Beshay N. Zordoky BSc, MSc, PhD , Karim T. Sadak MD, MPH, MSE","doi":"10.1016/j.jaccao.2025.01.008","DOIUrl":"10.1016/j.jaccao.2025.01.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 309-311"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834985","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":"Strengthening the Appreciation of Frailty in Patients With Transthyretin Cardiac Amyloidosis","authors":"Justin L. Grodin MD, MPH , Parag Goyal MD, MSc","doi":"10.1016/j.jaccao.2025.03.003","DOIUrl":"10.1016/j.jaccao.2025.03.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 279-281"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835000","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}
Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC), Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure), Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging), Bonnie Ky MD, MSCE (Editor-in-Chief, JACC: CardioOncology), Douglas L. Mann MD (Editor-in-Chief, JACC: Basic to Translational Science), David J. Moliterno MD (Editor-in-Chief, JACC: Cardiovascular Interventions), Kalyanam Shivkumar MD, PhD (Editor-in-Chief, JACC: Clinical Electrophysiology), Candice K. Silversides MD (Editor-in-Chief, JACC: Advances), Gilbert H.L. Tang MD, MSc, MBA (Editor-in-Chief, JACC: Case Reports), Jian’an Wang MD, PhD (Editor-in-Chief, JACC: Asia)
{"title":"Articulating the JACC Journals’ Direction in Times of Global Change","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC), Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure), Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging), Bonnie Ky MD, MSCE (Editor-in-Chief, JACC: CardioOncology), Douglas L. Mann MD (Editor-in-Chief, JACC: Basic to Translational Science), David J. Moliterno MD (Editor-in-Chief, JACC: Cardiovascular Interventions), Kalyanam Shivkumar MD, PhD (Editor-in-Chief, JACC: Clinical Electrophysiology), Candice K. Silversides MD (Editor-in-Chief, JACC: Advances), Gilbert H.L. Tang MD, MSc, MBA (Editor-in-Chief, JACC: Case Reports), Jian’an Wang MD, PhD (Editor-in-Chief, JACC: Asia)","doi":"10.1016/j.jaccao.2025.02.001","DOIUrl":"10.1016/j.jaccao.2025.02.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 322-323"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834868","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":"Enalapril for Preventing Cardiotoxicity After High-Dose Anthracycline Therapy in Breast Cancer and Lymphoma Patients","authors":"Daniela Cardinale MD, PhD , Giancarlo Marenzi MD","doi":"10.1016/j.jaccao.2025.01.014","DOIUrl":"10.1016/j.jaccao.2025.01.014","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 317-318"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834988","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}
Osnat Itzhaki Ben Zadok MD, MSc , Meabh J. O’Hare MBBCH , Anju Nohria MD, MSc
{"title":"Immune Checkpoint Inhibitor–Related Myocarditis With or Without Concomitant Myopathy","authors":"Osnat Itzhaki Ben Zadok MD, MSc , Meabh J. O’Hare MBBCH , Anju Nohria MD, MSc","doi":"10.1016/j.jaccao.2025.02.005","DOIUrl":"10.1016/j.jaccao.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Data on cardiovascular outcomes in patients with both immune checkpoint inhibitor–induced immune-related myocarditis (irMyocarditis) and immune-related myopathy (irMyopathy) are limited.</div></div><div><h3>Objectives</h3><div>The aim of this study was to describe clinical characteristics and cardiovascular outcomes in patients with isolated irMyocarditis vs those with concomitant irMyocarditis and irMyopathy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted among patients diagnosed with irMyocarditis at Massachusetts General Brigham between 2015 and 2023. Clinical, laboratory, and imaging characteristics were evaluated, and cardiovascular outcomes were compared between patients with and those without concomitant irMyopathy. The outcomes assessed included acute heart failure requiring diuresis, significant arrhythmias (ventricular arrhythmias and high-degree atrioventricular block), and cardiovascular and all-cause mortality during the index hospitalization.</div></div><div><h3>Results</h3><div>Among 101 patients with irMyocarditis, 32 (31.7%) had concomitant irMyopathy. Patients with irMyocarditis and irMyopathy had higher high-sensitivity troponin T (median 716 ng/L vs 75 ng/L; <em>P</em> < 0.001) and creatine kinase levels (median 3441 U/L vs 232 U/L; <em>P</em> < 0.001) and were more likely to present with significant arrhythmias (HR: 2.12; 95% CI: 1.13-3.97; <em>P</em> = 0.019). Conversely, patients with isolated irMyocarditis had higher N-terminal prohormone of brain natriuretic peptide levels (median 2043 pg/mL vs 606 pg/mL; <em>P</em> = 0.007), lower left ventricular ejection fractions (median 56% vs 65%; <em>P</em> = 0.008), and a higher likelihood of acute decompensated heart failure (HR: 5.88; 95% CI: 1.45-25; <em>P</em> = 0.013). Cardiovascular and all-cause death during admission were numerically higher in patients with concomitant irMyopathy but were not significantly different between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Patients with irMyocarditis and irMyopathy and those with isolated irMyocarditis have distinct biomarker profiles and cardiovascular complications. These differences should be confirmed in larger prospective cohorts to guide tailored management strategies.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 252-264"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834997","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}