Preemptive Cardioprotective Strategies in Patients Receiving Chemotherapy

Chemotherapy agents have greatly improved outcomes and survival of patients with cancer but have also been associated with significant cardiotoxicity. The advent of cardiotoxicity is detrimental to patients both during cancer therapy, by limiting the extent of therapy and therefore chance of cure, and also during cancer survivorship, by causing devastating cardiac morbidity and mortality. In this article, we not only review the types of agents most often associated with cardiotoxicity, proposed mechanisms of cardiac injury, but more importantly, how to attenuate or prevent it all together. We review the available data and evidence for different strategies to prevent cardiac damage during chemotherpathy and propose our own protocols for risk stratification, monitoring, and prevention of cardiotoxicity.