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急性冠脉综合征

Abstract

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A systematic review of factors predicting door to balloon time in ST-segment elevation myocardial infarction treated with percutaneous intervention Correlation and prognostic role of neutrophil to lymphocyte ratio and SYNTAX score in patients with acute myocardial infarction treated with percutaneous coronary intervention: A six-year experience Outcomes in Patients Treated With Thin-Strut, Very Thin-Strut, or Ultrathin-Strut Drug-Eluting Stents in Small Coronary Vessels: A Prespecified Analysis of the Randomized BIO-RESORT Trial Pharmacoinvasive and Primary Percutaneous Coronary Intervention Strategies in ST-Elevation Myocardial Infarction (from the Mayo Clinic STEMI Network) Symptom onset-to-balloon time and mortality in the first seven years after STEMI treated with primary percutaneous coronary intervention Oxygen Therapy in Suspected Acute Myocardial Infarction Aggressive Measures to Decrease Causes of delay and associated mortality in patients transferred with ST-segment-elevation myocardial infarction
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Expert OpinionDec 21, 2018

JOURNAL：ACC Article Link

Drug-Drug Interactions of Common Cardiac Medications and Chemotherapeutic Agents

S Zukkoor, V Thohan. Keywords: Drug-Drug Interaction; Cardiac Medication; chemotherapeutic agents

ABSTRACT

As the field of cardio-oncology evolves, the focus of treatment has shifted from reactive to proactive care. Prevention of cancer therapy-related cardiac dysfunction through optimization of cardiac risk factors and periodic surveillance, as well as minimal interruption of cancer treatment, is the emphasis of modern treatment paradigms.1 Cardio-protection frequently involves the initiation of cardiac medications, including certain beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs), and statins. Similarly, patients with pre-existing cardiac diseases are often prescribed a number of medications, such as anticoagulants and antiarrhythmics, that have potential and real interactions with a variety of chemotherapies. Because the therapeutic window for most chemotherapies is narrow, special attention should be given to these drug-drug interactions that may increase or decrease chemotherapeutic efficacy or predispose patients to serious unintended side effects. These drug-drug interactions are quite prevalent in the cancer population; one study determined that 16% of patients receiving oral anticancer drugs had at least one major drug-drug interaction that could cause harmful adverse effects.2 Health care providers should be aware of potential drug-drug interactions and mitigate risks as they manage cardiovascular health in the context of cancer treatment. In the following review of drug-drug interactions involving chemotherapeutic and common cardiac medications, areas of focus include typical pharmacokinetic (PK) and pharmacodynamic (PD) interactions, antithrombotics, and QT prolongation.



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