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接受心脏毒性治疗的肿瘤患者血脂异常的筛查与管理:一项意大利调查的结果

Screening and management of dyslipidemia in oncologic patients undergoing cardiotoxic therapies: results from an Italian survey.

作者信息

Camilli Massimiliano, Bisceglia Irma, Canale Maria Laura, Turazza Fabio Maria, De Luca Leonardo, Gabrielli Domenico, Gulizia Michele Massimo, Oliva Fabrizio, Colivicchi Furio

机构信息

Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.

Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Cardiooncology. 2023 Aug 5;9(1):32. doi: 10.1186/s40959-023-00183-0.

Abstract

BACKGROUND

Baseline cardiovascular risk factors correction is recommended in all cancer patients undergoing potentially cardiotoxic therapies. Despite available guidelines, real-world data on dyslipidemia prevalence and management in the oncologic population are still sparse.

METHODS

This survey was an Italian, investigator-initiated survey initially designed and drafted by the Cardio-Oncology section of the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), comprising 10 individual multi-choice questions and spread after validation through the ANMCO mailing list. The survey was sent to cardiologists working in cardio-oncology units and/or managing patients with cancer.

RESULTS

Our survey included 139 Italian cardiologists. The majority of them routinely ask for the baseline lipidic profile of their patients, regardless of previous clinical history and planned treatment. According to our participants, the estimated prevalence of dyslipidemia in this population is between 20% and 60%. Although this high prevalence, our results highlight that there is poor harmony in terms of scores for CV risk prediction used in clinical practice to guide drug prescription and baseline therapy optimization. On the same line, coronary artery calcium score is poorly used in this setting. At the same time, more than 30% of interrogated physicians do not prescribe adequate statin doses, even though necessary, and have uncertainties on the use of other anti-dyslipidemic drugs in this population.

CONCLUSIONS

Our results highlight the necessity of strong evidences on dyslipidemia screening and management in the cancer population, as well as the need of knowledge diffusion from scientific societies to clinicians treating these patients.

摘要

背景

对于所有接受可能具有心脏毒性治疗的癌症患者,建议纠正基线心血管危险因素。尽管有可用的指南,但关于肿瘤患者血脂异常患病率和管理的真实世界数据仍然稀少。

方法

这项调查是一项由意大利发起、由意大利国家医院心脏病专家协会(ANMCO)心脏肿瘤学部门最初设计和起草的调查,包括10个单项选择题,经验证后通过ANMCO邮件列表进行传播。该调查发送给了在心脏肿瘤学科室工作和/或治疗癌症患者的心脏病专家。

结果

我们的调查包括139名意大利心脏病专家。他们中的大多数人会常规询问患者的基线血脂情况,无论其既往临床病史和计划的治疗如何。根据我们的参与者,该人群中血脂异常的估计患病率在20%至60%之间。尽管患病率很高,但我们的结果表明,在临床实践中用于指导药物处方和基线治疗优化的心血管风险预测评分方面,存在不一致。同样,在这种情况下,冠状动脉钙化评分的使用也很少。与此同时,超过30%的受访医生即使有必要也不开具足够剂量的他汀类药物,并且在该人群中使用其他抗血脂异常药物方面存在不确定性。

结论

我们的结果强调了在癌症人群中进行血脂异常筛查和管理的有力证据的必要性,以及科学协会向治疗这些患者的临床医生传播知识的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e84/10403947/83ad28bea27c/40959_2023_183_Fig2_HTML.jpg

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