Another Milestone in the JACC Family of Journals: First Issue of JACC: CardioOncology Released

Get up to speed on the first issue of JACC: CardioOncology!

Another Milestone in the JACC Family of Journals: First Issue of JACC: CardioOncology Released

The first issue of ACC's newest JACC Journal, JACC: CardioOncology, provides a comprehensive new resource to better understand and apply evolving research surrounding the cardiovascular health of cancer patients and survivors.

The quarterly, open-access journal published online Sept. 24. Led by Editor-in-Chief Bonnie Ky, MD, MSCE, FACC, the first issue includes seven original research papers addressing safety and efficacy of drugs in preventing cardiotoxicity; blood pressure response to inhibitors; pre-diagnosis exercise and cardiovascular events in breast cancer; and more. Don't miss the clinical case challenge.


A state-of-the-art review, co-authored by Ky, looks at the evolving design of NIH-funded cardio-oncology studies to address cancer treatment-related cardiovascular toxicity. Another state-of-the-art review, authored by Ronald Witteles, MD, FACC, and Michaela Liedtke, MD, provides a review of AL amyloidosis for the cardiologist and oncologist. In a viewpoint article, Deepak L. Bhatt, MD, MPH, FACC, discusses the birth and maturation of cardio-oncology.

In the inaugural Editor's Page, Ky gives her guiding principles and vision for the journal. "Ultimately, JACC: CardioOncology is a tremendous opportunity to shape and transform the field of cardio-oncology into a mature field that focuses on scientific evidence, patient centeredness, community engagement, and multidisciplinary collaboration," she writes.

Visit to read the journal online and download the PDF of the first issue. Learn more about Dr. Ky and her plans for the journal in an interview published in June's issue of Cardiology at


JACC: CardioOncology Leadership Page: Cardio-Oncology: Stronger Together

In the Leadership Page published in the first issue of JACC: CardioOncology, Richard J. Kovacs, MD, FACC, president of the ACC, and Howard A. Burris III, MD, FASCO, president of the American Society of Clinical Oncology (ASCO), discuss the intersection of cardiovascular disease and cancer care and recognize the launch of the new journal.

Advancements in both specialties are helping patients live longer, but cardiac disease and cancer have similar rates of occurrence late in life and increasingly affect the same patients. Patients with cardiac disease who develop cancer, cancer patients with cardiovascular complications and the caregivers for these patients all face major challenges.


ACC and ASCO are similar specialty societies working towards improving outcomes for these patients.

"We stand shoulder to shoulder in the battle," Kovacs and Burris write. "We celebrate victories together and we mourn losses as colleagues. As we recognize the publication of the first edition of JACC: CardioOncology, we celebrate a new tool to aid in the fight: to publish new knowledge, to educate our members, to foster debate, and to advance the frontiers of this growing field. Ultimately, we strive to improve the quality of life for the patients we serve."


Exercise Prior to Breast Cancer Diagnosis Associated With Lower CVD Risk

Breast cancer patients who exercised before being diagnosed may be at a lower risk for cardiovascular disease compared with those who did not exercise, according to a study published in the inaugural issue of JACC: CardioOncology.

Tochi M. Okwuosa, DO, FACC, et al., examined 4,015 patients with a confirmed diagnosis of primary breast cancer enrolled in the Women's Health Initiative (WHI), which included postmenopausal women aged 50 to 79 years.

Women with cardiovascular disease, a history of any other malignancy prior to enrollment or a body mass index ≤18.5k g/m2 were excluded. Exercise history at baseline and follow-up were assessed with a questionnaire where patients reported the frequency, duration and intensity of leisure-time physical activity.


The researchers examined exercise data collected at the visit closest to breast cancer diagnosis and that was between five years and one month prior to diagnosis. Metabolic equivalent task (MET) values were assigned for levels of physical activity per week and exercise was categorized in quartiles: <2.50 MET-hours/week (994 patients); 2.50 to ≥8.625 (1,008 patients); 8.625 to <18.0 (1,011 patients); and ≥18.0 (1,002 patients).

During the study, 324 cardiovascular events occurred. The researchers found that exercising prior to a breast cancer diagnosis was associated with a 20 to 37 percent reduction in the risk of first cardiovascular events. The risk of myocardial infarction and heart failure was not impacted, suggesting that exercise may be associated with a greater risk reduction in other cardiovascular events such as angina, coronary revascularization, peripheral artery disease or stroke. Individuals meeting current physical activity recommendations (9 MET-hours/week), prior to diagnosis had a 46 percent lower risk of coronary heart disease death compared with those who exercised less than recommended.

According to the authors, patients who were more physically active prior to breast cancer diagnosis are likely to have a more favorable cardiovascular profile, including higher cardiorespiratory fitness. These patients may have a higher cardiovascular reserve capacity to tolerate the cardiovascular toxic effects that are sometimes experienced as a side effect of cancer treatment. These patients are also more likely to be more active during cancer treatment, which has, in other studies, found to be associated with a lower risk of cardiovascular events.

"As more and more patients survive their breast cancer, cardiovascular disease is and will continue to become a major risk of morbidity and mortality for survivors," write Lindsay L. Peterson, MD, MSCR, and Jennifer A. Ligibel, MD, in an editorial comment accompanying the paper. "Finding strategies to help patients engage in recommended amounts of physical activity prior to and after breast cancer diagnosis will be critical to improving outcomes in women with early breast cancer, in particular in the rising number of older adults with breast cancer."


Mark Your Calendar and Register Now!

Interested in learning more about advancing cardio-oncology? Ky also serves as a course director of the ACC's annual cardio-oncology course, Advancing the Cardiovascular Care of the Oncology Patient, which will be held in Washington, DC, from February 14-16, 2020.

Keywords: ACC Publications, Cardiology Magazine, Metabolic Equivalent, Peripheral Arterial Disease, Cardiotoxicity, Cardiotoxins, Caregivers, Body Mass Index, Leadership, Postmenopause, Quality of Life, Follow-Up Studies, Access to Information, Angina Pectoris, Myocardial Infarction, Heart Failure, Stroke, Coronary Disease, Blood Pressure, Risk Reduction Behavior, Breast Neoplasms, Exercise, Medical Oncology

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