Circulation. 2018 Feb 20;137(8):e30-e66. doi: 10.1161/CIR.0000000000000556. Epub 2018 Feb 1.
Cardiovascular disease (CVD) remains the leading cause of mortality in women, yet many people perceive breast cancer to be the number one threat to women's health. CVD and breast cancer have several overlapping risk factors, such as obesity and smoking. Additionally, current breast cancer treatments can have a negative impact on cardiovascular health (eg, left ventricular dysfunction, accelerated CVD), and for women with pre-existing CVD, this might influence cancer treatment decisions by both the patient and the provider. Improvements in early detection and treatment of breast cancer have led to an increasing number of breast cancer survivors who are at risk of long-term cardiac complications from cancer treatments. For older women, CVD poses a greater mortality threat than breast cancer itself. This is the first scientific statement from the American Heart Association on CVD and breast cancer. This document will provide a comprehensive overview of the prevalence of these diseases, shared risk factors, the cardiotoxic effects of therapy, and the prevention and treatment of CVD in breast cancer patients.
心血管疾病(CVD)仍然是女性死亡的主要原因,但许多人认为乳腺癌是女性健康的头号威胁。CVD 和乳腺癌有几个重叠的风险因素,如肥胖和吸烟。此外,目前的乳腺癌治疗方法可能对心血管健康产生负面影响(例如,左心室功能障碍、加速 CVD),对于已经患有 CVD 的女性,这可能会影响患者和提供者的癌症治疗决策。乳腺癌早期检测和治疗的改进导致越来越多的乳腺癌幸存者面临癌症治疗引起的长期心脏并发症风险。对于老年女性来说,CVD 比乳腺癌本身造成的死亡率威胁更大。这是美国心脏协会关于 CVD 和乳腺癌的第一份科学声明。本文档将全面概述这些疾病的患病率、共同的风险因素、治疗的心脏毒性作用,以及乳腺癌患者 CVD 的预防和治疗。