thank you so much for having it
today brief we i'm jewelry i'm a
cardio colleges and bitches and scientists a
stand right i really appreciate the opportunity
to talk about our recent ha scientific
statement on the impact the hormonal therapies
for treating women depending cancers most notably
breast
and process cancers that was published in
circulation genomics precision medicine this year in
april so as you know cancer and
cardiovascular diseases are at the top two
causes of that than the u s
in regards to cancer breast and prostate
cancers most common nicotine is cancers and
women and men and respectively of her
monotherapy such as as selective estrogen receptor
modulators aromatase inhibitors and entered in the
pre recent therapy self serve as a
backbone retreating these cancers
i'm in which have improved survival of
cancer patients profoundly however these hormonal therapy
is have also been associated with increased
cardiovascular morbidity and mortality among cancer patients
and survivors in particular as these patients
continue to live longer cardiovascular disease has
really mers as a leading cause of
mortality and
mobility and this population so test by
ha cardio college you subcommittee a group
of but last led by dr to
chief a sat at rush university and
doctor he at ismail khan it might
be cancer center came together and reviewed
cardiovascular impact of hormonal therapies
specifically reviewed cardiovascular diseases and risk associated
with specific ramona therapies and also suggest
is some evidence based approach to prevent
and detect these potential adverse cardiovascular outcomes
in this population we also highlighted that
much more research and studies are needed
in the space especially in regards to
the fact new generation combined therapies as
well as how the duration of therapies
marginally disrupt risk as many patients are
often treated with these and ramona mana
therapies for years if not lifelong additionally
there remain concerns related to patient at
related to racial and ethnic disparities of
cardiovascular outcome is falling hormonal therapies finally
with think it is critical to have
a multidisciplinary approach to implement prevented it
and therapeutic strategies to effectively manage and
reduce cardiovascular risk during and after the
hormonal therapies
yes so endocrine therapy for breast cancer
includes selected estrogen receptor modulators such as
to marks a fan and the roma
tease inhibitor such as nasa's all to
max a thin increases the risk of
been a struggle and a drum been
like events like db t and t
he whereas aromatase inhibitors are associated with
overall higher risk of cardiovascular events when
compared to the max have been in
addition aromatase inhibitors has been associated with
increase rates of metabolic syndrome to slip
it in yeah and hypertension sometimes patients
with hormone dependent breast cancer such as
year pierre posit
a cancers can develop what's called end
can be distance in which case is
they are peace targeting course you believe
it a pathway such as p actors
k ag t and them toward pathways
be combined with conventional and the korean
therapies which has been shown to improve
response rate and delay the time to
disease progression but these
combat companies and therapies have also been
associated with higher rates of adverse cardiovascular
events including hypertension prolonged t t t
v t and each of the bullish
and
yeah so androgen deprivation therapy i can
be done surgically via are key actor
me a medically i'm using it or
gwinnett a trip and realising herman agonists
such a liberal lied or antagonists such
thick become bigger relics as well as
as
well as androgen receptor directed they are
peace such as abbey road or on
or akita corners all and eighty ti
rendered and the provision therapy can induce
really broad spectrum metabolic effects such as
increase el dia and triglyceride levels increase
our visceral fat decrees lean body mass
and increase insulin resistance
they're also associated with and with arterial
and venus them when mike events and
increase rates of acute and my heart
failure and the rhythm yes and combined
androgen blockade at the rp with cannot
a trip any realising from an agonising
first generation androgen receptor antagonist have been
shown to induce more increase more intense
it's testosterone reduction for prostate cancer but
this combination has been also shows associated
with increased cardiovascular death and events compared
to know treat men with and without
without eighty ti
yes if patients early outlet he had
cardiovascular disease or cardiovascular risk factors at
baseline then they're more likely to be
at risk for subsequent events when they
are treat it were hormonal therapies for
example if patients i'm had pre existing
hypertension dyslipidemia or diabetes in there at
a higher risk for having cardio
bass player side effect when when they're
treated hormone hormonal piece on the other
hand hormone therapy themselves i can increase
your risk of these cardiovascular risk factors
so when you combine all of death
he can either edits usually or synergistically
increased downstream risk of cardiovascular disease and
this population additional
limited data also suggests that the length
of time on therapy can increase the
risk of cardiovascular events
so thus far limited data to date
suggest that and there could be potential
racial and ethnic disparity related to cardiovascular
outcomes and this could be due to
either differential cardiovascular effects and this and
and and patients with different recess or
difference isn't baseline cardiovascular risk factors which
may be late
to help inequities ass or any for
investigations and racial and ethnic differences in
cardiovascular outcomes are associated with hormonal therapy
is of be critical additionally occurring additionally
no definite a by lines regarding how
best to monitor and manage hormonal therapy
related cardio toxicity which have been point
to develop
lastly we also need respected the are
comparing our these hormonal therapies and their
cardiovascular our comes especially middle east and
to duration of they are peace
yeah suffers and cardiologist need to know
or or need to be aware the
hormonal therapies indeed increase cardiovascular risk it
is it's also really important apply and
follow standard american heart association guidelines and
recommendations to or cardiovascular disease and even
in cancer patients treated when hormonal therapy
is if anything
a lord dress for to monitor and
manage cardiovascular risk factors and diseases or
be warranted as these therapies over a
put patients at a higher risk for
cardiovascular events and during and after a
hormonal they are fees and finally a
multidisciplinary approach to patient for the patient
care and is important
and by involving patients as well as
the care teams including cardiovascular and cancer
teams am so dead in and we
can really optimize our patients on colossi
can cardiovascular outcomes