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Registro OBELISCO-SAC OBsErvaciones de cLinicas, Instituciones y Servicios de Cardio-Oncología SAC

2022; Sociedad Argentina de Cardiología; Volume: 90; Issue: 6 Linguagem: Inglês

10.7775/rac.es.v90.i6.20575

1850-3748

Silvia Makhoul, Jorge A. Lax, Karina Palacios, Jimena Gambarte, Fernanda Petrucci, Patricio Servienti, Florencia Perazzo, Natalia Zaręba, Myriam Núñez, Germán Calabrese,

Cardiovascular Effects of Exercise

Background: Cardio-oncology (CO) is a new discipline that generates new work areas within the institutions. We ignore how manyCO teams exist in our country, their structure and how patients are managed.Objectives: Our primary objective is to report how many CO centers exist in our country, and how many of them work according tothe recommendations of guidelines and consensus statements. We also want to define the specialty and specific training of the physicians involved, determine if they perform risk assessment before cancer treatment, establish the method used to assess ventricular function and how biomarkers are used.Methods: The OBELISCO registry is a national, multicenter, cross-sectional, descriptive and prospective registry including 51 general hospitals, cancer centers and institutions specialized in cardiology with CO work groups or services.Results: Of the 51 centers, 47.1% were public and 52.9% were private. Most centers were in the Autonomous City of Buenos Aires(49%) and in the Province of Buenos Aires and the rest were distributed throughout the country. Of 47 centers, 48.9% consideredthat their institution had CO services complying with the recommendations of international guidelines and the consensus statementof the Argentine Society of Cardiology. Global cardio-oncological or cardiovascular risk assessment is always performed in 27.7% ofthe centers before starting treatment. Patients who will start potentially cardiotoxic treatment are always referred to Cardiology in35.3% of the centers and are sometimes referred to Cardiology in 47.1%. Baseline echocardiography is performed in all the patientsbefore starting treatment in 43.1% of the centers and only in some patients in 56.9%. During follow-up, echocardiography is indicated according to the treatment schedule used in 64.7% and according to the patients' outcome in the rest of the centers. All the centers evaluate left ventricular ejection fraction with echocardiography, and 68.1% use two-dimensional echocardiography. Global longitudinal systolic strain is used in 63.8% of the centers. Only 47.1% order cardiac magnetic resonance imaging in some patients, and 35.3% indicate cardiac computed tomography scan. Biomarkers are used in only 7.8% of the centers. Primary prevention with neurohormonal antagonist drugs is always indicated in 5.9% of the centers. Dexrazoxane is used in only 5.9% and liposomal anthracycline in 74.5%. If cardiotoxicity develops, 76.5% indicate cardioprotection, 41% discontinue chemotheraphy and 47% modify cancer treatment.Conclusions: This is the first national CO registry. It provides information and a current outlook of the status of this subspecialtyin our country. Almost 50% of the centers considered to be functioning in line with guidelines and consensus statements. Only inone third of centers, the patients who will initiate cancer treatment with potentially cardiotoxic drugs are referred to CO. Two-dimensional echocardiography is the method most used in our country to evaluate ventricular function; biomarkers are scarcely used