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32. Cardiovascular Nursing
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Cardiovascular determinants of chemotherapy suspension in a cohort of patients with high cardiovascular risk
Session:
Posters (Sessão 1 - Écran 2) - Cardio-oncologia
Speaker:
Isabel Cardoso
Congress:
CPC 2023
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Isabel Cardoso; Vera Ferreira; Tânia Mano; Inês Guerreiro; Leonor Fernandes; André Grazina; José Viegas; Bárbara Teixeira; Pedro Rio; Luís Almeida Morais; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> The development of new cancer therapies has prolonged the lifespan of the oncologic population. However, cardiovascular (CV) events during cancer treatment are a concerning cause of morbidity and mortality. Adverse cardiovascular events can lead to permanent suspension of cancer therapies, affecting the overall survival of these patients (P). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objectives:</strong> To describe cardiovascular events and risk factors leading to suspension of cancer treatment in a cohort of patients with high cardiovascular risk. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>We conducted a retrospective analysis of all P referred to the cardio-oncology outpatient clinic between May 2021 and October 2022. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>178P were included, 80 males (45%), median age of 69 (IQR 61-77) years, with a high burden of CV risk factors (42% of the patients had 2 or more CV risk factors) undergoing treatment for different types of cancer (Table 1). During follow-up 25P (14%) suspended cancer treatment. The cardiovascular causes for therapy suspension were heterogenous: 12P (48%) discontinued therapy due to left ventricle systolic disfunction (LVSD), 5P (20%) due to new onset of atrial fibrillation or atrial flutter, 2P (8%) due to coronary vasospasm, 3P (12%) for acute coronary syndromes during treatment, 2P (8%) due to myocarditis and 1P (4%) due to right ventricle disfunction. All the patients with LVSD initiated cardioprotective therapy, the 2P diagnosed with atrial flutter underwent catheter ablation and the patients with atrial fibrillation remained asymptomatic after medical therapy adjustment. In total 11P (44%) were able to resume therapy. A significant increase in high sensitive troponin (superior to 25% from baseline) during follow-up was identified has a risk factor for therapy suspension (p=0.03). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion</strong>: In our cohort of patients with high cardiovascular risk, 14% had a cardiovascular event that led to discontinuation of cancer treatments. Cardiac biomarker troponin had an important role in identifying patients at risk. Close monitoring in a dedicated cardio-oncology outpatient clinic favoured promptly optimization of cardioprotective therapies and allowed 44% of patients to resume oncologic treatments. </span></span></p>
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