Fiuza Manuela, Magalhães Andreia, Nobre Menezes Miguel, Costa Paula, Abreu Ribeiro Leonor, Abreu Catarina, Brás Raquel, Vieira Joana, Duarte Ana I, Morais Pedro, Silva Beatriz, Costa Luís, Pinto Fausto J
Cardio-Oncology Unit, Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte - EPE, Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
Cardio-Oncology Unit, Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte - EPE, Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
Rev Port Cardiol. 2022 Dec;41(12):979-984. doi: 10.1016/j.repc.2021.07.014. Epub 2022 Sep 22.
Heart disease and cancer are the two leading causes of morbidity and mortality worldwide. Advances in cancer screening and management have led to longer survival and better quality of life. Despite this progress, many cancer patients experience cardiovascular complications during and after cancer treatment. This study describes the experience of a cardio-oncology program at tertiary academic hospital.
In this retrospective observational study, cancer patients referred to the CHULN cardio-oncology consultation (COC) between January 2016 and December of 2019 were included. Data collected included: patient demographics, cancer type, reason for referral, cardiovascular risk factors, cardiac and oncologic treatments and clinical outcomes.
A total of 520 patients (mean age: 65 ± 14 years; 65% women) were referred to the COC. The main reasons for referral were suspected heart failure (26%), pre-high risk chemotherapy assessment (20%) and decreased LVEF (15%). Pre-existing cardiovascular risk factors were common (79%) and 309 (59%) were taking cardiac medications. The most common type of malignancy was breast cancer (216, 41%) followed by gastrointestinal (139, 27%). More than half received anthracycline-based regimens (303, 58%). Most patients (401; 77%) successfully completed cancer therapy. At the time of last data collection, the majority of patients were alive (430, 83%). Cardiac-related mortality was observed in 16%.
The close collaboration between cardiology and oncology teams and timely cardiac monitoring was the key to the majority of patients to completing their prescribed cancer therapy.
心脏病和癌症是全球发病和死亡的两大主要原因。癌症筛查和治疗方面的进展使患者生存期延长，生活质量提高。尽管取得了这些进展，但许多癌症患者在癌症治疗期间及之后仍会出现心血管并发症。本研究描述了一家三级学术医院心脏肿瘤项目的情况。
在这项回顾性观察研究中，纳入了2016年1月至2019年12月间转诊至CHULN心脏肿瘤会诊（COC）的癌症患者。收集的数据包括：患者人口统计学资料、癌症类型、转诊原因、心血管危险因素、心脏和肿瘤治疗情况以及临床结局。
共有520例患者（平均年龄：65±14岁；65%为女性）转诊至COC。转诊的主要原因是疑似心力衰竭（26%）、高风险化疗前评估（20%）和左心室射血分数降低（15%）。既往存在心血管危险因素很常见（79%），309例（59%）正在服用心脏药物。最常见的恶性肿瘤类型是乳腺癌（216例，41%），其次是胃肠道癌（139例，27%）。超过一半的患者接受了基于蒽环类药物的方案（303例，58%）。大多数患者（401例；77%）成功完成了癌症治疗。在最后一次数据收集时，大多数患者仍存活（430例，83%）。观察到心脏相关死亡率为16%。
心脏病学和肿瘤学团队之间的密切合作以及及时的心脏监测是大多数患者完成规定癌症治疗的关键。
