Jacc: Cardiooncology最新文献

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(25)00135-8","DOIUrl":"10.1016/S2666-0873(25)00135-8","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages I-CXXXVII"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834869","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":"Personalized Trastuzumab-Induced Cardiac Dysfunction Risk Stratification and Surveillance","authors":"Fengqi Fang MD , Xinxin Zhang MD , Junjie Li MD","doi":"10.1016/j.jaccao.2025.01.011","DOIUrl":"10.1016/j.jaccao.2025.01.011","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 216-218"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834994","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":"Immune Checkpoint Inhibitor Myocarditis and Left Ventricular Systolic Dysfunction","authors":"Yen-Chou Chen MD ,&nbsp;Charles Dolladille MD, PhD ,&nbsp;Anjali Rao MD ,&nbsp;Nicolas L. Palaskas MD ,&nbsp;Anita Deswal MD, MPH ,&nbsp;Lorenz Lehmann MD ,&nbsp;Jennifer Cautela MD ,&nbsp;Pierre-Yves Courand MD, PhD ,&nbsp;Salim Hayek MD, PhD ,&nbsp;Han Zhu MD ,&nbsp;Richard K. Cheng MD, MSc ,&nbsp;Joachim Alexandre MD, PhD ,&nbsp;Lauren A. Baldassarre MD ,&nbsp;François Roubille MD ,&nbsp;Michal Laufer-Perl MD ,&nbsp;Aarti Asnani MD ,&nbsp;Stephane Ederhy MD ,&nbsp;Yuichi Tamura MD, PhD ,&nbsp;Sanjeev Francis MD ,&nbsp;Elizabeth M. Gaughan MD ,&nbsp;Vlad G. Zaha MD, PhD, MBA","doi":"10.1016/j.jaccao.2025.01.020","DOIUrl":"10.1016/j.jaccao.2025.01.020","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, but ICI myocarditis (ICI-M) remains a potentially fatal complication. The clinical implications and predictors of left ventricular ejection fraction (LVEF) &lt;50% in ICI-M are not well understood.</div></div><div><h3>Objectives</h3><div>The aim of this study was to identify factors associated with LVEF &lt;50% vs ≥50% at the time of hospitalization for ICI-M. A secondary objective was to evaluate the relationship between LVEF and 30-day all-cause mortality.</div></div><div><h3>Methods</h3><div>The International ICI-Myocarditis Registry, a retrospective, international, multicenter database, included 757 patients hospitalized with ICI-M. Patients were stratified by LVEF as reduced LVEF (&lt;50%) or preserved LVEF (≥50%) on admission. Cox proportional hazards models were used to assess the associations between LVEF and clinical events, and multivariable logistic regression was conducted to examine factors linked to LVEF.</div></div><div><h3>Results</h3><div>Of 757 patients, 707 had documented LVEFs on admission: 244 (35%) with LVEF &lt;50% and 463 (65%) with LVEF ≥50%. Compared with patients with LVEF ≥50%, those with LVEF &lt;50% were younger (&lt;70 years), had a body mass index of &lt;25 kg/m², and were more likely to have received chest radiation (24.2% vs 13.5%; <em>P</em> &lt; 0.001). Multivariable analysis identified predictors of LVEF &lt;50%, including exposure to v-raf murine sarcoma viral oncogene homolog B1/mitogen-activated protein kinase inhibitors, pre-existing heart failure, dyspnea at presentation, and at least 40 days from ICI initiation to ICI-M onset. Conversely, myositis symptoms were associated with LVEF ≥50%. LVEF &lt;50% was marginally associated with 30-day all-cause mortality (unadjusted log-rank <em>P</em> = 0.062; adjusted for age, cancer types, and ICI therapy, HR: 1.50; 95% CI: 1.02-2.20).</div></div><div><h3>Conclusions</h3><div>Dyspnea, time from ICI initiation, a history of heart failure, and prior cardiotoxic therapy may be predictors of an initial LVEF &lt;50% in patients with ICI-M.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 234-248"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834995","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":"Fluoropyrimidine Chemotherapy and the Risk of Death and Cardiovascular Events in Patients With Gastrointestinal Cancer.","authors":"Aderonke T Abiodun, Chengsheng Ju, Catherine A Welch, Jennifer Lai, Freya Tyrer, Pinkie Chambers, Lizz Paley, Sally Vernon, John Deanfield, Mark de Belder, Mark J Rutherford, Paul C Lambert, Sarah Slater, Kai-Keen Shiu, Li Wei, Michael D Peake, David Adlam, Charlotte Manisty","doi":"10.1016/j.jaccao.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jaccao.2025.01.019","url":null,"abstract":"<p><strong>Background: </strong>Fluoropyrimidine chemotherapy is administered first-line for many gastrointestinal cancers. However, patients with cardiovascular disease commonly receive alternative treatment due to cardiotoxicity concerns.</p><p><strong>Objectives: </strong>The study sought to assess the risks of all-cause mortality and acute cardiovascular events with fluoropyrimidine treatment.</p><p><strong>Methods: </strong>We conducted an observational cohort study applying a target trial emulation framework to linked national cancer, cardiac, and hospitalization registry data from the Virtual Cardio-Oncology Research Initiative. Adults diagnosed with tumors eligible for fluoropyrimidine-based chemotherapy as first-line therapy were included. All-cause mortality and a composite of hospitalization for acute cardiovascular events (acute coronary syndrome, heart failure, cardiac arrhythmia, cardiac intervention, cardiac arrest, and cardiac death) were compared in patients treated with fluoropyrimidine-based chemotherapy vs alternative management. Adjusted, weighted pooled logistic regression models were used to estimate the 1-year risk difference (RD).</p><p><strong>Results: </strong>Among 103,110 patients (mean age 69.7 years, 59% male), the absolute risk of death at 1 year was significantly lower in fluoropyrimidine-treated patients (RD: -7.7%; 95% CI: -8.7% to -6.7%) with a small increased risk of acute cardiovascular events (RD: 0.9%; 95% CI: 0.0% to 1.9%). This was primarily due to arrhythmias (RD: 0.8%; 95% CI: 0.1% to 1.6%) and cardiac arrest (RD: 0.3%; 95% CI: 0.1% to 0.5%), with no increased risk of acute coronary syndromes including in the subgroup of patients with pre-existing coronary artery disease.</p><p><strong>Conclusions: </strong>The markedly improved overall survival with fluoropyrimidines in patients with gastrointestinal cancer significantly outweighs the small risk of cardiac arrhythmia and arrest. Oncologists should take this into consideration for decision making to avoid undue clinical conservatism, particularly in patients with cardiovascular disease.</p>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812582","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":"Fluoropyrimidine Therapy in Gastrointestinal Cancer: Balancing Survival Benefits and Cardiotoxicity Risks.","authors":"Mohamad Bassam Sonbol, Tanios Bekaii-Saab, Carolyn M Larsen","doi":"10.1016/j.jaccao.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.jaccao.2025.02.006","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812674","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":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(25)00022-5","DOIUrl":"10.1016/S2666-0873(25)00022-5","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages I-CXII"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436491","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":"The Association of Malignancy With Stroke and Bleeding in Atrial Fibrillation","authors":"Malak El-Rayes MD ,&nbsp;Mohamed Adam MSc ,&nbsp;Jiming Fang PhD ,&nbsp;Xuesong Wang MSc ,&nbsp;Irene Jeong MSc ,&nbsp;Peter C. Austin PhD ,&nbsp;Andrew C.T. Ha MD ,&nbsp;Michael G. Fradley MD ,&nbsp;Thomas A. Boyle MD ,&nbsp;Eitan Amir MB ChB, PhD ,&nbsp;Paaladinesh Thavendiranathan MD, MSc ,&nbsp;Husam Abdel-Qadir MD, PhD","doi":"10.1016/j.jaccao.2024.10.014","DOIUrl":"10.1016/j.jaccao.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>It is undetermined if malignancy independently increases stroke risk in atrial fibrillation (AF).</div></div><div><h3>Objectives</h3><div>This study sought to determine the association of malignancy with stroke and bleeding in AF.</div></div><div><h3>Methods</h3><div>Population-based cohort study using administrative datasets of people aged ≥66 years with newly diagnosed AF. People diagnosed with malignancy within 5 years before AF diagnosis were matched to cancer-free control subjects on age, sex, AF diagnosis details, CHA₂DS₂-VASc score, and ATRIA bleeding score. Outcomes included hospitalizations for stroke and hospitalization/emergency visits for bleeding. Cause-specific regression was used to determine the HR for malignancy after adjusting for time-varying anticoagulation status. Analyses were repeated for specific subgroups of cancer patients (with matched control subjects).</div></div><div><h3>Results</h3><div>Among 199,710 AF patients, 24,991 (12.5%) people had prior malignancy. Malignancy was associated with more inpatient diagnoses of AF (vs outpatient) and less anticoagulation. We matched 43,802 people with AF (21,901 with malignancy, mean age 78.1 years; 59.5% male). After adjusting for anticoagulation status, malignancy had a similar hazard of stroke (HR: 1.01; 95% CI: 0.88-1.15) but higher hazard of bleeding (HR: 1.45; 95% CI: 1.37-1.53) compared with cancer-free control subjects in the matched sample. Analyses of cancer subgroups with comparison to matched control subjects mostly showed consistent results, except for: 1) increased hazard of stroke in lung cancer; and 2) lack of increased bleeding hazard in breast cancer and lymphoma.</div></div><div><h3>Conclusions</h3><div>People with AF and malignancy generally had similar hazards of stroke but higher hazards of bleeding compared with cancer-free control subjects, suggesting that malignancy should not lower the threshold for anticoagulation in AF.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 157-167"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437060","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":"Editorial Board/ACC Officers Page","authors":"","doi":"10.1016/S2666-0873(25)00020-1","DOIUrl":"10.1016/S2666-0873(25)00020-1","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages i-iv"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436492","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":"Withdrawal of Cardioprotective Therapy in Patients With Recovered Cancer Therapy–Related Cardiac Dysfunction","authors":"Yuma Shibutani PhD,&nbsp;Takuro Imaoka MD,&nbsp;Atsuko Suzuki BSc,&nbsp;Kazuko Tajiri MD, PhD","doi":"10.1016/j.jaccao.2024.11.010","DOIUrl":"10.1016/j.jaccao.2024.11.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Page 189"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437051","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":"Effects of Systemic Anticancer Treatment on Cardiorespiratory Fitness","authors":"Sara H. Johansen MSc ,&nbsp;Torbjørn Wisløff PhD ,&nbsp;Elisabeth Edvardsen PhD ,&nbsp;Sofie T. Kollerud MSc ,&nbsp;Johanne S.S. Jensen MSc ,&nbsp;Ginika Agwu BAc ,&nbsp;Konstantina Matsoukas MLIS ,&nbsp;Jessica M. Scott PhD ,&nbsp;Tormod S. Nilsen PhD","doi":"10.1016/j.jaccao.2024.11.004","DOIUrl":"10.1016/j.jaccao.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Poor cardiorespiratory fitness (CRF) is associated with a higher symptom burden and an increased prevalence of long-term treatment–related cardiovascular disease risk factors in cancer survivors. However, the magnitude of systemic therapy–related CRF impairment remains unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the effects of systemic anticancer treatment on CRF and identify physiological determinants underpinning CRF impairment.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed in PubMed, Embase, CINAHL, SPORTDiscus, and the Cochrane Library. The primary endpoint was the change in CRF, measured by peak oxygen consumption (V<span>o</span>_2peak), from before to after systemic treatment. Secondary endpoints included post-treatment differences in V<span>o</span>_2peak between cancer survivors and noncancer control subjects, along with physiological determinants of V<span>o</span>_2peak. Two meta-regressions were conducted to examine the association between CRF and cardiac output and arteriovenous oxygen difference.</div></div><div><h3>Results</h3><div>A total of 44 studies were included, comprising 27 prospective trials (61%; n = 1,234 cancer survivors, median age 52.4 years) and 17 cross-sectional studies (39%; n = 1,372 cancer survivors, median age 54.0 years; n = 1,923 noncancer control subjects, median age 56.0 years). Systemic anticancer treatment was associated with a significant decrease in V<span>o</span>_2peak (weighted mean difference −2.13 mL·kg⁻¹·min⁻¹; 95% CI: −2.76 to −1.50 mL·kg⁻¹·min⁻¹). No significant differences were observed between patient subgroups (esophagogastric, breast, and colon or rectal cancers). At a median follow-up of 2 years (range: 6 weeks to 12 years) post-therapy, cancer survivors had a significantly lower V<span>o</span>_2peak (weighted mean difference −6.39 mL·kg⁻¹·min⁻¹; 95% CI: −7.60 to −5.18 mL·kg⁻¹·min⁻¹) compared with noncancer control subjects. Reduced arteriovenous oxygen difference was associated with lower V<span>o</span>_2peak (β = 2.55; 95% CI: 2.05-3.06; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Systemic anticancer treatment leads to substantial and sustained impairments in CRF.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 96-106"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437052","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}