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Cardio-oncology, from Guidelines to Practice: Filling the Gap - an Eastern European Viewpoint
Andreea Cristina Ivănescu1,2, Patricia Lorena Dulf3,4, Daniel Vasile Dulf3,5
1Department 4, Carol Davila University of Medicine and Pharmacy Bucharest, Romania.
European Cardiology
|May 22, 2026
Summary
Cardio-oncology guideline implementation varies in Romania, with specialized centers showing better adherence. Gaps in cardiovascular care for cancer patients highlight the need for national programs and training.
Area of Science:
- Cardiology
- Oncology
- Public Health
Background:
- Cardio-oncology guidelines aim to manage cardiovascular risks in cancer patients.
- Real-world implementation of these guidelines faces challenges, especially in resource-limited settings.
Purpose of the Study:
- To assess the application of evidence-based cardiovascular prevention, surveillance, and management strategies by Romanian physicians treating cancer patients.
- To compare Romanian practices with international cardio-oncology data.
Main Methods:
- An anonymous, national online survey was conducted from September to November 2024.
- The survey targeted cardiologists, oncologists, haematologists, and internists, assessing institutional context, clinical practices, and adherence to international recommendations.
- 190 responses were analyzed.
Main Results:
- Centers with dedicated cardio-oncology teams and university affiliation more consistently applied risk stratification, monitored toxicity, and prescribed prophylactic pharmacotherapy.
- Centers lacking these resources showed less consistent implementation of cardioprotective strategies and long-term follow-up.
- Cardiologists were more proactive than oncologists in managing early cardiac dysfunction and modifying cancer therapy.
Conclusions:
- Cardio-oncology practice in Romania is heterogeneous, influenced by specialty, institutional resources, and experience.
- There is a clear need for structured national programs and interdisciplinary training to improve cardio-oncology care for cancer patients in Romania.
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