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@article{Pareek:2018:10.1002/ejhf.1292,
author = {Pareek, N and Cevallos, J and Moliner, P and Shah, M and Tan, LL and Chambers, V and Baksi, AJ and Khattar, RS and Sharma, R and Rosen, SD and Lyon, AR},
doi = {10.1002/ejhf.1292},
journal = {European Journal of Heart Failure},
pages = {1721--1731},
title = {Activity and outcomes of a cardio-oncology service in the United Kingdom - a five-year experience},
url = {http://dx.doi.org/10.1002/ejhf.1292},
volume = {20},
year = {2018}
}

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TY  - JOUR
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.
AU  - Pareek,N
AU  - Cevallos,J
AU  - Moliner,P
AU  - Shah,M
AU  - Tan,LL
AU  - Chambers,V
AU  - Baksi,AJ
AU  - Khattar,RS
AU  - Sharma,R
AU  - Rosen,SD
AU  - Lyon,AR
DO  - 10.1002/ejhf.1292
EP  - 1731
PY  - 2018///
SN  - 1388-9842
SP  - 1721
TI  - Activity and outcomes of a cardio-oncology service in the United Kingdom - a five-year experience
T2  - European Journal of Heart Failure
UR  - http://dx.doi.org/10.1002/ejhf.1292
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30191649
UR  - http://hdl.handle.net/10044/1/62851
VL  - 20
ER  -

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