Abstract
The inevitability of cardiac injury in many patients treated for cancer mandates strategies
to mitigate the effect of cancer treatment on the heart. In this article we argue
that the best approach to prevent cardiotoxicity is universal primary prevention for
everyone at risk for irreversible myocardial injury. Our viewpoint is on the basis
of 5 major arguments that we discuss in detail in this article. We outline the shortcomings
of alternate strategies for prevention and highlight that the strongest existing evidence
today supports our viewpoint. In particular, data from multiple randomized controlled
trials indicate that most patients who receive anthracyclines are at risk, and should
be accordingly considered for primary prevention.
Résumé
Comme les lésions cardiaques sont inévitables chez bon nombre de patients recevant
un traitement anticancéreux, il est nécessaire de mettre en place des stratégies pour
atténuer les effets de ce type de traitement sur le cœur. Dans cet article, nous soutenons
que le meilleur moyen de prévenir la cardiotoxicité est la prévention primaire systématique
chez les patients à risque de lésion myocardique irréversible. Notre position est
étayée par 5 arguments importants présentés en détail dans cet article. Nous soulignons
les faiblesses des autres stratégies et le fait que les données existantes les plus
probantes corroborent notre point de vue. Il est particulièrement à noter que les
données provenant de multiples études contrôlées à répartition aléatoire indiquent
que la plupart des patients qui reçoivent des anthracyclines sont exposés à un risque
et, par conséquent, il faudrait, dans ces cas, envisager la prévention primaire.
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Article info
Publication history
Published online: April 26, 2016
Accepted:
April 19,
2016
Received:
April 19,
2016
Footnotes
See article by Davis and Virani, pages 926-930 of this issue.
See page 924 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
