Jacc: Cardiooncology最新文献

{"title":"Prognosis After Withdrawal of Cardioprotective Therapy in Patients With Improved Cancer Therapeutics–Related Cardiac Dysfunction","authors":"Hyukjin Park MD ,&nbsp;Nuri Lee MD ,&nbsp;Cho Hee Hwang MPH ,&nbsp;Sang-Geon Cho MD ,&nbsp;Ga Hui Choi MD ,&nbsp;Jae Yeong Cho MD ,&nbsp;Hyun Ju Yoon MD ,&nbsp;Kye Hun Kim MD ,&nbsp;Youngkeun Ahn MD","doi":"10.1016/j.jaccao.2024.07.018","DOIUrl":"10.1016/j.jaccao.2024.07.018","url":null,"abstract":"<div><h3>Background</h3><div>The long-term prognosis after the discontinuation of cardioprotective therapy (CPT) in patients with cancer therapeutics–related cardiac dysfunction (CTRCD) that has shown improvement remains unclear.</div></div><div><h3>Objectives</h3><div>This study aims to assess the prognosis after CPT withdrawal in patients exhibiting improved CTRCD.</div></div><div><h3>Methods</h3><div>In this retrospective analysis of a single-center prospective cohort study, patients with improved CTRCD, defined as an increase in left ventricular ejection fraction (LVEF) ≥10 percentage points from the time of CTRCD diagnosis, were included. We analyzed their clinical outcomes, which included hospitalization for heart failure or a decrease in LVEF ≥10 percentage points within 2 years after CTRCD improvement, alongside echocardiographic changes.</div></div><div><h3>Results</h3><div>The cohort comprised 134 patients with improved CTRCD. The median follow-up duration after CTRCD diagnosis was 368.3 days (Q1-Q3: 160-536 days). After improvement, 90 patients continued CPT (continued group [CG]) and 44 withdrew CPT (withdrawn group [WG]). Among patients whose baseline LVEF at CTRCD diagnosis ranged from 45% to 55%, the final mean LVEF was comparable between both groups (CG: 64.9% ± 4.4% vs WG: 62.9% ± 4.2%; <em>P</em> = 0.059). However, for patients with a baseline LVEF &lt;45%, the final mean LVEF was significantly lower in the WG (CG: 53.3% ± 6.4% vs WG: 48.2% ± 6.9%; <em>P</em> &lt; 0.001). The occurrence of composite major clinical events was notably higher in the WG (HR: 3.06; 95% CI: 1.51-7.73; <em>P</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Patients who withdrew CPT after demonstrating improvement in CTRCD experienced worse clinical outcomes. Notably, a significant decrease in LVEF was observed after CPT withdrawal in patients with a baseline LVEF &lt;45%.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 699-710"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437693","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":"Priorities in Cardio-Oncology","authors":"Bonnie Ky MD, MSCE, FACC","doi":"10.1016/j.jaccao.2024.09.002","DOIUrl":"10.1016/j.jaccao.2024.09.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Page 811"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438319","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":"Guiding Treatment With Recovered CTRCD","authors":"Brian P. Halliday MBChB, PhD ,&nbsp;Muhummad Sohaib Nazir MBBS, PhD","doi":"10.1016/j.jaccao.2024.09.003","DOIUrl":"10.1016/j.jaccao.2024.09.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 711-713"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438322","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":"Epigenomics of Cardio-Oncology","authors":"Brian T. Joyce PhD","doi":"10.1016/j.jaccao.2024.07.013","DOIUrl":"10.1016/j.jaccao.2024.07.013","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 743-745"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437700","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":"Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes for Preclinical Cardiotoxicity Screening in Cardio-Oncology","authors":"Kyle D. Shead MRes,&nbsp;Eline Huethorst PhD,&nbsp;Francis Burton PhD,&nbsp;Ninian N. Lang MBChB, PhD,&nbsp;Rachel C. Myles MBChB, PhD,&nbsp;Godfrey L. Smith PhD","doi":"10.1016/j.jaccao.2024.07.012","DOIUrl":"10.1016/j.jaccao.2024.07.012","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 678-683"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437642","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":"Life’s Essential 8 and Incident Cardiovascular Disease in U.S. Women With Breast Cancer","authors":"Elena Wadden MD ,&nbsp;Alexi Vasbinder PhD, RN ,&nbsp;Vidhushei Yogeswaran MD ,&nbsp;Aladdin H. Shadyab PhD ,&nbsp;Nazmus Saquib MBBS, MPH, PhD ,&nbsp;Yangbo Sun PhD ,&nbsp;Lisa Warsinger Martin MD ,&nbsp;Ramesh Mazhari MD ,&nbsp;JoAnn E. Manson MD, DrPH ,&nbsp;Marcia Stefanick PhD ,&nbsp;Ana Barac MD, PhD ,&nbsp;Michael S. Simon MD ,&nbsp;Kerryn Reding PhD, MPH, RN ,&nbsp;Richard K. Cheng MD, MS","doi":"10.1016/j.jaccao.2024.07.008","DOIUrl":"10.1016/j.jaccao.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Relationships between lifestyle risk factors and cardiovascular disease (CVD) risk in women with breast cancer (BC) are underexplored.</div></div><div><h3>Objectives</h3><div>To evaluate the incidence of CVD in relation to the Life’s Essential 8 (LE8) score among women with BC.</div></div><div><h3>Methods</h3><div>Data from the Women’s Health Initiative were utilized. The primary exposure was the LE8 score assessed prior to BC diagnosis. The LE8 score was stratified into low (0-59), moderate (60-79), and high (80-100) cardiovascular health (CVH). The primary endpoint was a composite of incident CVD events, which included coronary heart disease, defined as myocardial infarction along with coronary revascularization, CVD death, and stroke. We calculated the cumulative incidence of CVD and estimated hazard ratios.</div></div><div><h3>Results</h3><div>Among 7,165 participants, the median age was 70.1 years at BC diagnosis. The mean LE8 score was 62.0 ± 12.2. Over a median follow-up period of 6 years, 490 composite CVD events occurred. The risk of CVD events was highest for low CVH compared with moderate and high CVH. Compared with low CVH, the hazard ratio for incident CVD was 0.57 (95% CI: 0.46-0.69) for moderate CVH and 0.34 (95% CI: 0.20-0.59) for high CVH. LE8, in conjunction with age, provided a C-statistic of 0.74 for the composite risk of CVD.</div></div><div><h3>Conclusions</h3><div>Higher LE8 scores were associated with a lower risk of incident CVD among women with BC in the United States.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 746-757"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437649","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":"Measuring “Cardiovascular Health” in Everyone Including Cancer Patients","authors":"Tochi M. Okwuosa DO ,&nbsp;Donald Lloyd-Jones MD","doi":"10.1016/j.jaccao.2024.08.003","DOIUrl":"10.1016/j.jaccao.2024.08.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 758-760"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437650","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":"Preventing Cancer Therapy–Related Cardiotoxicity","authors":"Antonio Cannata MD ,&nbsp;Theresa McDonagh MB ChB, MD","doi":"10.1016/j.jaccao.2024.09.001","DOIUrl":"10.1016/j.jaccao.2024.09.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 697-698"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437692","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":"Steroids in Immune Checkpoint Inhibitor Myocarditis","authors":"Nicolas L. Palaskas MD, MPH ,&nbsp;Bilal A. Siddiqui MD ,&nbsp;Anita Deswal MD, MPH","doi":"10.1016/j.jaccao.2024.07.002","DOIUrl":"10.1016/j.jaccao.2024.07.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 800-803"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437696","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":"Use of Polygenic Risk Score for Prediction of Heart Failure in Cancer Survivors","authors":"Cheng Hwee Soh PhD ,&nbsp;RuiDong Xiang PhD ,&nbsp;Fumihiko Takeuchi PhD ,&nbsp;Thomas H. Marwick MBBS, PhD, MPH","doi":"10.1016/j.jaccao.2024.04.010","DOIUrl":"10.1016/j.jaccao.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><div>The risk for heart failure (HF) is increased among cancer survivors, but predicting individual HF risk is difficult. Polygenic risk scores (PRS) for HF prediction summarize the combined effects of multiple genetic variants specific to the individual.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare clinical HF prediction models with PRS in both cancer and noncancer populations.</div></div><div><h3>Methods</h3><div>Cancer and HF diagnoses were identified using International Classification of Diseases-10th Revision codes. HF risk was calculated using the ARIC (Atherosclerosis Risk in Communities) HF score (ARIC-HF). The PRS for HF (PRS-HF) was calculated according to the Global Biobank Meta-analysis Initiative. The predictive performance of the ARIC-HF and PRS-HF was compared using the area under the curve (AUC) in both cancer and noncancer populations.</div></div><div><h3>Results</h3><div>After excluding 2,644 participants with HF prior to consent, 440,813 participants without cancer (mean age 57 years, 53% women) and 43,720 cancer survivors (mean age 60 years, 65% women) were identified at baseline. Both the ARIC-HF and PRS-HF were significant predictors of incident HF after adjustment for chronic kidney disease, overall health rating, and total cholesterol. The PRS-HF performed poorly in predicting HF among cancer (AUC: 0.552; 95% CI: 0.539-0.564) and noncancer (AUC: 0.561; 95% CI: 0.556-0.566) populations. However, the ARIC-HF predicted incident HF in the noncancer population (AUC: 0.804; 95% CI: 0.800-0.808) and provided acceptable performance among cancer survivors (AUC: 0.748; 95% CI: 0.737-0.758).</div></div><div><h3>Conclusions</h3><div>The prediction of HF on the basis of conventional risk factors using the ARIC-HF score is superior compared to the PRS, in cancer survivors, and especially among the noncancer population.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 5","pages":"Pages 714-727"},"PeriodicalIF":12.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437697","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}