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急性冠脉综合征

Abstract

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Australian Trends in Procedural Characteristics and Outcomes in Patients Undergoing Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China Association of Plaque Location and Vessel Geometry Determined by Coronary Computed Tomographic Angiography With Future Acute Coronary Syndrome–Causing Culprit Lesions Risk Stratification Guided by the Index of Microcirculatory Resistance and Left Ventricular End-Diastolic Pressure in Acute Myocardial Infarction Effect of improved door-to-balloon time on clinical outcomes in patients with ST segment elevation myocardial infarction National assessment of early β-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI Study Outcome of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention during on- versus off-hours (a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] trial substudy) 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infa
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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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