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2021, Número 1

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Cardiovasc Metab Sci 2021; 32 (1)


Cardio-Oncología Toxicidad cardiovascular y antineoplásicos

Harrison RD, Armenta VD, Sánchez LF, Harrison GC

Idioma: Inglés [English version]
Referencias bibliográficas: 57
Paginas: 42-55
Archivo PDF: 341.30 Kb.


RESUMEN

El último siglo ha sido testigo de un incremento sin precedentes en la expectativa de vida, principalmente por la disminución en las enfermedades infecciosas como causa de mortalidad. En forma paralela, se ha observado un cambio en la mortalidad hacia causas no-infecciosas, como enfermedad cardiovascular y cáncer. Con las nuevas terapias antineoplásicas se ha incrementado la población de sobrevivientes de cáncer a largo plazo; ahora se sabe que algunas de estas terapias incrementan el riesgo de enfermedad cardiovascular, ya que en los últimos 20 a 30 años se ha observado una mayor prevalencia de insuficiencia cardiaca, cardiopatía isquémica, arritmias e hipertensión arterial en sobrevivientes de cáncer. En este artículo revisamos aspectos generales relacionados a terapia antineoplásica, incluyendo mecanismos de acción de los agentes anticancerosos de uso más común, además de aspectos sobre la nomenclatura de inhibidores de tirosina quinasa y clasificación de cardiotoxicidad. La variedad de agentes anticáncer se incrementa día a día y de manera breve hacemos una descripción de diferentes drogas antineoplásicas, incluyendo agentes terapéuticos tradicionales y los nuevos que afectan blancos terapéuticos específicos, agentes inmunooncológicos y su relación con toxicidad cardiovascular. Los factores de riesgo cardiovascular clínicos clásicamente conocidos son predictores de potencial cardiotoxicidad, y junto con biomarcadores y técnicas de imagen han facilitado el diagnóstico temprano de cardiotoxicidad en estadios subclínicos/asintomáticos, lo cual permite implementar medidas preventivas. Ha habido también avances terapéuticos en la fase sintomática que serán discutidos. Esta es un área en evolución continua y es conveniente involucrar la mente del cardiólogo general en este, relativamente nuevo, tópico, en el entendido de que no en todas partes existen unidades especializadas de cardio-oncología; sin embargo, como cardiólogos debemos colaborar con oncólogos en el tratamiento de pacientes con cáncer.


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