Classification, prevalence, and outcomes of anticancer thera
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To understand the relationship among cancer, cancer therapy, and CV disease, researchers conducted a prospective, multicentre registry (CARDIOvascular TOXicity induced by cancer-related therapies; CARDIOTOX registry).

While a significant number of patients exhibited evidence of myocardial injury or dysfunction related to cancer therapy, only patients with severe cardiotoxicity, defined here as an asymptomatic decrease in LVEF <40% or clinical heart failure, were at higher risk of all-cause death.

The authors reported findings from the CARDIOTOX registry; a multicenter prospective cohort of adult patients receiving chemotherapy associated with a reported incidence of cardiotoxicity of more than 2%. The study examined the association between various definitions of cardiotoxicity and outcomes
1. Mild: asymptomatic patients with left ventricular ejection fraction [LVEF] ≥50% with elevated biomarkers.
2.Moderate: asymptomatic patients with LVEF 40-50% with or without biomarker increases;
3. Severe: asymptomatic with LVEF <40% or clinical heart failure).
A total of 865 registry participants (mean age 55, 16% men, 66% with breast cancer, and 85% having received anthracyclines) were followed for a median of 2 years. Cardiotoxicity was identified in 38% of patients during follow-up: 32% with mild, 3% moderate, and 3% with severe cardiotoxicity.

Understanding cardiotoxicity warrants the prospective and systematic cardiovascular evaluation of patients undergoing cancer therapy, which is the purpose of the CARDIOTOX registry. The early findings are insightful: In the span of 2 years, while 38% of patients had signs of myocardial injury or dysfunction, 3% were severely impacted and had a higher risk of all-cause death. These findings should not be interpreted as the lack of clinical significance for milder forms of myocardial injury.

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