Few Cardiologists, Oncologists ‘Very Comfortable’ Treating CV Complications in Cancer Patients, Survey Shows

JACC:  CardioOncology

Less than one-fifth of both cardiologists and oncologists in a recent survey report feeling "very comfortable" treating patients with cardiovascular complications secondary to cancer treatments, according to a study published Sept. 15 in JACC: CardioOncology.

As part of a collaboration between ACC's Florida Chapter and the Florida American Society of Clinical Oncology (FLASCO), Diego Sadler, MD, FACC, et al., administered a survey to members of both groups to determine the educational needs of cardiologists and oncologists who treat cancer patients and develop education materials designed to bridge knowledge gaps.

A 16-question survey was sent to all members of ACC's Florida Chapter and FLASCO. In total, 303 physicians completed the surveys, including 138 Florida ACC members and 165 FLASCO members. According to the results, 22 cardiologists (16%) and 23 oncologists (14%) reported feeling "very comfortable" treating patients with cardiovascular complications related to cancer treatment. Less than half of the respondents believed there is optimal cooperation between the two specialties. More than half of cardiologists said their knowledge of cardio-oncology was average (28.4%) or below average (35.8%), while 52.8% of oncologists said their knowledge of cardio-oncology was above average.

Oncologists reported they consulted general cardiology (58%) more often than cardio-oncology (38%) for evaluation of treatment-related cardiotoxicity. Primary barriers to establishing a cardio-oncology program included lack of awareness (63%) and lack of funding (40%). Among oncologists, 29% reported treating patients with potential cardiotoxicities more than once per week. Oncologists were most likely to suggest cardiac evaluations for patients receiving anthracyclines (95%), trastuzumab (88%), vascular endothelial growth factor inhibitors (55%), multitargeted tyrosine kinase inhibitors (47%) and immune checkpoint inhibitors (39%). The most common cardiotoxicities included left ventricular ejection fraction (84%), arrhythmias and atrial fibrillation (43%), arterial or venous thromboembolism (42%), and QT prolongation (36%).

Based on the survey's results, the researchers developed a cardio-oncology education program, available on web-based platforms of ACC's Florida Chapter and FLASCO. The program includes monthly emails and educational documents on topics that are fundamental to cardio-oncology. According to the researchers, the survey "highlights the need for further awareness, advocacy and education in the growing field of cardio-oncology." The next step, they write, is to establish a multistate network of ACC and ASCO state chapters, enabling different states to use similar platforms to assess needs, close knowledge gaps and "provide enhanced care for cardio-oncology patients."

Clinical Topics: Arrhythmias and Clinical EP, Cardio-Oncology, Pulmonary Hypertension and Venous Thromboembolism, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Cardiotoxicity, Anthracyclines, Vascular Endothelial Growth Factor A, Atrial Fibrillation, Venous Thromboembolism, Stroke Volume, Ventricular Function, Left, Cardiology, Medical Oncology, Heart Diseases

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