PMID- 30191649
OWN - NLM
STAT- MEDLINE
DCOM- 20190327
LR  - 20191210
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 20
IP  - 12
DP  - 2018 Dec
TI  - Activity and outcomes of a cardio-oncology service in the United Kingdom-a 
      five-year experience.
PG  - 1721-1731
LID - 10.1002/ejhf.1292 [doi]
AB  - AIMS: Cardio-oncology clinics optimise the cardiovascular status of cancer 
      patients but there is a limited description of their structure, case mix, 
      activity and results. The purpose of this paper is to describe the activity and 
      outcomes of a cardio-oncology service, particularly with respect to supporting 
      optimal cancer treatment and survival. METHODS AND RESULTS: We prospectively 
      studied patients referred to our service from February 2011 to February 2016. New 
      York Heart Association (NYHA) class and parameters of cardiac function were 
      measured at baseline and after optimisation by our service. Up-titration of 
      cardiac treatment, continuation of cancer therapy and mortality were used as 
      outcome measures. Of the 535 patients (55.8% females) referred, rates of 
      cardiotoxicity for anthracyclines, anti-HER2 agents and tyrosine kinase 
      inhibitors were 75.8%, 69.8% and 62.1%, respectively. Patients with left 
      ventricular systolic dysfunction (LVSD) (n =128) were younger, had higher rates 
      of hypertension and previous exposure to chemotherapy/radiotherapy (P < 0.001). 
      At a median follow-up of 360 days, 93.8% of the patients with LVSD showed 
      improvement in left ventricular ejection fraction (45% pre vs. 53% post; P < 
      0.001) and NYHA class (NYHA III-IV in 22% pre vs. 10% post; P = 0.01). All 
      patients with normal left ventricular ejection fraction and biochemical or 
      functional myocardial toxicity and 88% of patients with LVSD were deemed fit for 
      continuation of cancer therapy after cardiovascular optimisation. CONCLUSIONS: 
      Through the establishment of a cardio-oncology service, it is feasible to achieve 
      high rates of cardiac optimisation and cancer treatment continuation.
CI  - (c) 2018 The Authors. European Journal of Heart Failure (c) 2018 European Society of 
      Cardiology.
FAU - Pareek, Nilesh
AU  - Pareek N
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Cevallos, Joaquim
AU  - Cevallos J
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Moliner, Pedro
AU  - Moliner P
AD  - Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
FAU - Shah, Mit
AU  - Shah M
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Tan, Li Ling
AU  - Tan LL
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Chambers, Vicki
AU  - Chambers V
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Baksi, A John
AU  - Baksi AJ
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Khattar, Rajdeep S
AU  - Khattar RS
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Sharma, Rakesh
AU  - Sharma R
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
FAU - Rosen, Stuart D
AU  - Rosen SD
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
AD  - National Heart and Lung Institute, Imperial College, London, UK.
FAU - Lyon, Alexander R
AU  - Lyon AR
AD  - Royal Brompton and Harefield NHS Foundation Trust, London, UK.
AD  - National Heart and Lung Institute, Imperial College, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20180906
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
CIN - Eur J Heart Fail. 2018 Dec;20(12):1732-1734. PMID: 30328667
MH  - Cardiology/*methods
MH  - Comorbidity/trends
MH  - *Disease Management
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Diseases/epidemiology/*therapy
MH  - Humans
MH  - Male
MH  - Medical Oncology/*methods
MH  - Middle Aged
MH  - Neoplasms/epidemiology/*therapy
MH  - *Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
MH  - United Kingdom/epidemiology
OTO - NOTNLM
OT  - Cancer
OT  - Cardiotoxicity
OT  - Heart failure
EDAT- 2018/09/08 06:00
MHDA- 2019/03/28 06:00
CRDT- 2018/09/08 06:00
PHST- 2018/03/01 00:00 [received]
PHST- 2018/06/29 00:00 [revised]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/09/08 06:00 [pubmed]
PHST- 2019/03/28 06:00 [medline]
PHST- 2018/09/08 06:00 [entrez]
AID - 10.1002/ejhf.1292 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2018 Dec;20(12):1721-1731. doi: 10.1002/ejhf.1292. Epub 2018 
      Sep 6.