Evolving Cardioprotective Strategies in Cardio-Oncology: A Narrative Review

Patients living with cancer are at risk for significant potential cardiovascular complications as a direct result of cancer treatment or due to underlying comorbid cardiovascular disease. This article reviews the methods of risk stratification as well as pharmacologic and nonpharmacologic approaches to cardioprotection in cardio-oncology.

Several cancer-specific risk stratification tools have incorporated variables such as age, sex, cancer subtype, traditional cardiovascular risk factors and cancer treatment-related parameters to assess cardiovascular specific risk prior to cancer therapy. Cardioprotective strategies, namely neurohormonal blockade and statins, have yielded mixed results in patients with cancer. Non-pharmacologic strategies, including exercise and dietary interventions, have shown potentially promising results in observational and randomized studies. Ultimately, the optimal cardioprotective strategy should be personalized based on each patient's unique risk profile and clinical context. Further research is needed to better define the role of cardioprotection across different cancer subtypes and cardiovascular risk groups, with an emphasis on refining individualized prevention and treatment strategies.