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Prevention of cancer therapy-related cardiac dysfunction and heart failure in cancer patients and survivors. A Clinical Consensus Statement of the Heart Failure Association, the European Association of Preventive Cardiology of the ESC, and the ESC Council of Cardio-Oncology

  • Amina Rakisheva
  • , Dimitrios Farmakis
  • , Andrea Attanasio
  • , Antoni Bayes Genis
  • , Alain Cohen-Solal
  • , Geeta Gulati
  • , Martin Halle
  • , Loreena Hill
  • , Teresa Lopez Fernandez
  • , Alexander R Lyon
  • , Brenda Moura
  • , Ciro Santoro
  • , Carlo Gabriele Tocchetti
  • , Sophie van Linthout
  • , Vassilios Vassiliou
  • , Yusuf Ziya Sener
  • , Makhabbat Bekbosynova
  • , Marco Metra
  • , Giuseppe Rosano
  • , Massimo Piepoli

Research output: Contribution to journalArticlepeer-review

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Abstract

Despite advances in cancer treatments with significant improvement in patient outcomes, chemotherapy, targeted molecular therapies and radiotherapy may cause a range of cardiovascular complications, such as cancer therapy-related cardiac dysfunction (CTRCD), which represents a broad spectrum of possible presentation and aetiological link with the broad scope of various cancer therapies, including chemotherapy, targeted agents, immunotherapies, and radiation therapy, aiming at reducing the associated morbidity and mortality. However, practical guidelines on the primary prevention of CTRCD in high-risk patients, a key element in improving prognosis, are lacking in cancer patients and related evidence remains inconclusive. This Clinical Consensus Statement, authored by experts from the Heart Failure Association (HFA) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC), and the ESC Council of Cardio-Oncology, aims to discuss the definition and epidemiology of CTRCD, the implicated factors for risk stratification, and the appropriate early diagnostic pathways, while focusing on lifestyle modifications, and pharmacological interventions to reduce the incidence of CTRCD. In addition, a holistic cardio-oncology management approach is advised for prevention and long-term management.

Original languageEnglish
Pages (from-to)2084-2099
Number of pages16
JournalEuropean Journal of Heart Failure
Volume27
Issue number11
Early online date18 Jul 2025
DOIs
Publication statusPublished (in print/issue) - 30 Nov 2025

Bibliographical note

Publisher Copyright:
© 2025 European Society of Cardiology.

Funding

A.R.L. is supported by the Fondation Leducq Network of Excellence in Cardio-Oncology and the Royal Brompton Cardio-Oncology Centre of Excellence is supported by The Big Heart Foundation. C.G.T. is supported by two grants from the Italian Ministry of Health (PNRR-MAD-2022-12376632 and PNRR-MCNT2-2023-12376981). G.R. was supported by the Italian Ministry of Health (Ricerca Corrente) 20/1819. [Correction added on 17 November 2025, after first online publication: In the preceding sentence, the Italian Ministry of Health funding statement for Giuseppe Rosano has been added in this version.]

FundersFunder number
AstraZeneca
Novartis
Bristol-Myers Squibb
MEDTRONIC
Pfizer
Ministero della SalutePNRR‐MCNT2‐2023‐12376981, PNRR‐MAD‐2022‐12376632

    UN SDGs

    This output contributes to the following UN Sustainable Development Goals (SDGs)

    1. SDG 3 - Good Health and Well-being
      SDG 3 Good Health and Well-being

    Keywords

    • Cancer therapy‐related cardiac dysfunction
    • Heart failure prevention
    • Cancer patients and survivors
    • Cancer therapy-related cardiac dysfunction
    • Cancer Survivors
    • Heart Failure/prevention & control
    • Humans
    • Europe
    • Consensus
    • Neoplasms/therapy
    • Societies, Medical
    • Antineoplastic Agents/adverse effects
    • Cardiotoxicity/prevention & control
    • Cardiology
    • Cardio-Oncology

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