Cardioprotection in women with neoplastic disease

Abstract

Cardiotoxicity (CTX) is a serious adverse effect of anticancer drugs that impacts on quality of life and overall survival of cancer patients. Hypokinetic cardiomyopathy is the most typical form of CTX, and it is traditionally considered refractory to therapy. Prevention of CTX remains of paramount importance, and several measures, including serial cardiac function monitoring, reduction of cumulative anthracycline dose, use of anthracycline analogues and cardioprotective agents, have been proposed. Over the last decade, however, a new approach based on cardiac biomarkers has emerged as an effective alternative strategy for the early detection of subclinical cardiac injury. In particular, the role of troponin I in identifying patients at risk of CTX as well as of angiotensin-converting enzyme inhibitors in preventing left ventricular dysfunction and late cardiac events in high-risk patients, namely those with raised troponin I levels after chemotherapy, has been consistently demonstrated as an effective tool for CTX prevention.