KARDIOTOKSIČNOST ANTINEOPLASTIČNE TERAPIJE – MEHANIZMI NASTANKA, KLINIČKE MANIFESTACIJE I OSNOVNI POSTULATI KARDIO-ONKOLOGIJE
Kardiotoksičnost antineoplastične terapije
Sažetak
Maligne bolesti i kardiovaskularne bolesti su najčešći uzroci morbiditeta i mortaliteta savremenog sveta. Uzimajući u obzir starenje populacije razvijenih zemalja i činjenicu da su maligne bolesti uglavnom bolesti starijeg životnog doba, projektovani porast broja obolelih u zemljama Evropske unije, do 2040. godine, iznosi preko 20%. Savremena, personalizovana terapija malignih bolesti, koja je značajno poboljšala prognozu i preživljavanje hemato-onkoloških bolesnika, podrazumeva i njihovo brižljivo ambulantno praćenje, kako bi se prevenirali, pravovremeno dijagnostikovali i adekvatno lečili neposredni i kasni neželjeni efekti antineoplastične terapije. Kardiovaskularni sistem je, s obzirom na specifičnost građe i funkcije, posebno osetljiv na antineoplastične agense. Personalizovani i multidisciplinarni pristup u lečenju i praćenju hemato-onkoloških bolesnika je doveo do razvoja nove subspecijalnosti – kardio-onkologije, čiji je osnovni zadatak rano identifikovanje onkoloških bolesnika, sa ili bez pridruženih kardiovaskularnih bolesti, koji imaju povećani rizik od nastanka kardiotoksičnosti uzrokovane hemato-onkološkom terapijom. U radu su navedeni osnovni mehanizmi kardiotoksičnosti najvažnijih grupa antineoplastičnih lekova, kliničke manifestacije, kao i savremene preporuke za primarnu i sekundarnu prevenciju.
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