与癌症治疗相关的动脉高血压和心血管不良事件的风险分层和管理:来自皮埃蒙特和奥斯塔山谷(意大利西北部)肿瘤网络的共识文件

G. Mingrone, Elena Coletti Moia, Erica Delsignore, G. Demicheli, P. Destefanis, D. Forno, G. Giglio Tos, A. Luciano, G. Pinna, L. Ravera, A. Fava, F. Veglio, O. Bertetto, A. Milan
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引用次数: 1

摘要

接受潜在心脏毒性肿瘤治疗的癌症患者心血管不良事件(CVAEs)的风险增加,特别是在伴有动脉高血压(AH)的情况下。因此,癌症患者应在心脏毒性治疗之前、期间和之后进行评估,以早期识别新发或恶化的AH或CVAEs。来自Piedmont和Aosta Valley(意大利西北部)的肿瘤网络专家小组旨在提供建议,以支持卫生专业人员选择最佳的患者管理策略,同时考虑到诊断/治疗工具对结果的影响和风险-收益比。我们提出了一份评估和管理与癌症治疗相关的AH的有用文件。在开始潜在心脏毒性治疗之前,应将患者分为4个心血管(CV)风险组:低/中度风险患者应由肿瘤学家进行全面评估,高/极高风险患者应转诊心脏病专家或动脉高血压专家。根据心血管风险等级,每位患者在癌症治疗期间都应进行随访,以监测任何可能的心血管并发症。充分控制与抗肿瘤治疗相关的AH对于预防严重CVAEs至关重要。在存在高风险或对降压治疗缺乏反应的情况下,患者应在心血管肿瘤专家中心进行管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk Stratification and Management of Arterial Hypertension and Cardiovascular Adverse Events Related to Cancer Treatments: An Oncology Network from Piedmont and Aosta Valley (North-Western Italy) Consensus Document
Cancer patients receiving a potentially cardiotoxic oncologic therapy have an increased risk of cardiovascular adverse events (CVAEs), especially in presence of concomitant arterial hypertension (AH). Therefore, cancer patients should be evaluated before, during and after cardiotoxic treatments, to early identify new-onset or worsening AH or CVAEs. An expert panel of oncology networks from Piedmont and Aosta Valley (North-Western Italy) aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk–benefit ratio of diagnostic/therapeutic tools. We proposed an useful document for evaluating and managing AH related to cancer treatments. Patients should be divided into 4 cardiovascular (CV) risk groups before starting potentially cardiotoxic therapies: patients with low/moderate risk who should be entirely evaluated by oncologists and patients with high/very high risk who should be referred to a cardiologist or arterial hypertension specialist. According to the CV risk class, every patient should be followed up during cancer treatment to monitor any possible CV complications. Adequate control of AH related to antineoplastic treatments is crucial to prevent severe CVAEs. In the presence of high-profile risk or lack of response to anti-hypertensive therapy, the patients should be managed with a cardiovascular-oncology expert center.
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