用口服瘤学药物治疗心血管不良事件的心脏瘤干预的现实数据
Karen Abboud1, Godsfavour Umoru1, Barry Trachtenberg2
1Department of Pharmacy, Houston Methodist Hospital, Houston, TX, USA.
Cardio-oncology (London, England)
|April 9, 2024
概括
口腔癌药物的心血管毒性很常见,特别是在患有心脏病的患者中. 管理通常涉及中断治疗和开始药物治疗,但需要进一步优化.
科学领域:
- 心脏瘤学是一门专业.
- 在瘤学瘤学.
- 心血管医学 心血管医学
背景情况:
- 口服瘤学药物引起的心血管 (CV) 毒性呈现出各种各样的临床问题,如心律失常,心肌病变和心肌梗塞.
- 对于管理这些心血管不良事件的临床证据有限.
- 这项研究描述了与口服瘤学药物相关的CV事件的心脏瘤干预措施.
研究的目的:
- 在接受口服瘤治疗药物的患者中,对心血管不良事件的心脏瘤干预的特征.
- 为了识别与心脏毒性相关的常见口服瘤学药物.
- 评估与口腔癌治疗相关的心血管毒性管理策略.
主要方法:
- 在2016年6月至2021年7月期间入院的67名患者的回顾性队列研究.
- 纳入标准:具有心脏毒性潜力的口服瘤治疗药物和心脏毒性事件启动后的ICD10代码.
- 收集关于患者特征,瘤学药物,心脏毒性事件和干预措施的数据.
主要成果:
- 大多数患者 (97%) 患有先前存在的心血管疾病 (CVD) 或心血管风险因素.
- 常见的口服抗瘤药物包括芳酶抑制剂 (36%),BCR-ABL抑制剂 (16%),VEGFR抑制剂 (13%).
- 新发作或恶化的心力衰竭是最常见的心脏毒性事件 (n=31),发生在平均148天后. 药物治疗 (n=44) 和治疗中断 (n=18) 是常见的干预措施,有空间优化HF指南导向药物治疗.
结论:
- 预先存在的心血管疾病或心血管疾病风险因素增加了瘤患者对心血管疾病不良事件的敏感性.
- 真实世界CV事件的管理包括治疗中断和药物治疗的启动.
- 建议采用以患者为中心的多学科方法,包括风险/益处讨论和指导方针导向的治疗,等待药物特定数据.
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