Addressing the long-term cardiovascular risks of cardiotoxic therapies and emphasizing the critical role of lifestyle interventions in enhancing the health and well-being of cancer survivors: Systemic Review and Meta-analysis
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Background
The increasing survival rates of cancer patients have led to a growing population of cancer survivors, but the long-term cardiovascular risks associated with cardiotoxic cancer therapies remain a significant concern. These therapies, including chemotherapy, radiation, and targeted treatments, are known to increase the risk of cardiovascular diseases (CVD) such as heart failure, arrhythmias, and ischemic heart disease.
Methods
This meta-analysis, conducted according to PRISMA guidelines, aimed to evaluate the prevalence and risk factors of heart failure in adult cancer survivors exposed to cardiotoxic therapies. A systematic search was performed across PubMed, Scopus, Embase, and CENTRAL, identifying 35 randomized controlled trials (RCTs) with a total of 275,485 patients. Subgroup analyses compared cancer therapies with and without cardiotoxic effects, and meta-regression was performed to assess the impact of cofactors like hypertension, diabetes, and chemotherapy agents.
Results
A total of 35 RCTs, involving 275,485 patients, were included. The analysis showed a 42% increased risk of heart failure in cancer survivors exposed to cardiotoxic treatments (Risk Ratio [RR] 0.08; 95% CI: −0.57; 0.73). Hypertension (Z = 4.75, P = 0.000), diabetes (Z = −4.87, P = 0.000), and anthracycline use (Z = 2.08, P = 0.037) were significant risk factors. Subgroup analyses demonstrated higher heart failure rates in those receiving anthracyclines.
Conclusion
Comprehensive cardiovascular monitoring and lifestyle interventions are essential for mitigating the long-term cardiovascular risks in cancer survivors, improving their health outcomes and quality of life.
