Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector3848810.18821/0869-2106-2018-24-6-316-323ArticlesСтатьиReview ArticleABILITY TO PREVENT AND TREAT THE CARDIOVASCULAR SYSTEM DAMAGES, CAUSED BY THE USE OF ANTI-CANCER DRUGSВОЗМОЖНОСТИ ПРОФИЛАКТИКИ И ЛЕЧЕНИЯ ПОРАЖЕНИЙ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ, ВЫЗВАННЫХ ПРИМЕНЕНИЕМ ПРОТИВООПУХОЛЕВЫХ ПРЕПАРАТОВIbragimovaA. AИбрагимоваА. АEmelinaE. IЕмелинаЕ. ИGendlinGennady E.ГендлинГеннадий Ефимович

doktor of medical sciences, professor, Department of Hospital Therapy №. 2 “N. I. Pirogov Russian National Research Medical University”; 117997, Moscow, Russian Federation

доктор мед. наук, профессор кафедры госпитальной терапии № 2 ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, 117997, г. Москва

rgmugt2@mail.ruNikitinI. GНикитинИ. ГN.I. Pirogov Russian National Research Medical UniversityФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России15122018246VOL 24, NO6 (2018)ТОМ 24, №6 (2018)31632321072020Copyright ©; 2018, Eco-VectorCopyright ©; 2018, ООО "Эко-Вектор"2018Eco-VectorООО "Эко-Вектор"https://medjrf.com/0869-2106/article/view/38488

This review presents modern strategies for the prevention and treatment of cardiotoxicity induced by the most commonly used anticancer drugs such as anthracycline antibiotics, monoclonal antibodies, tyrosine kinase inhibitors. There are a large number of conflicting data on ways to overcome the cardiotoxicity of anticancer drugs. The creation of a complex of diagnostic measures will allow to identify the earliest signs of heart damage during chemotherapy and to develop timely preventive measures to prevent cardiotoxicity, improve the quality of life and prognosis of patients. Currently, a large number of small publications on the prevalence, prediction and prevention of cardiotoxicity in cancer patients, including the primary and secondary prevention of cardiotoxicity, are available. Beta-blockers and inhibitors of angiotensin-converting enzyme most often use as cardioprotective agents. There is evidence of poor tolerability of treatment with these drugs for young patients. Most drugs reduce blood pressure, which can adversely affect the health of patients without associated hypertension. Coordinated work between cardiologists and oncologists is needed to create common terminology, to define cardiovascular events and create registers, meta-analyzes, generally accepted recommendations, guidelines for the management of patients at risk of developing cardiotoxicity. This review used published articles the Scopus, Pubmed database, articles from The New England Journal of Medicine, Annals of Oncology, and periodicals of the Russian Federation over the past 10 years, as well as publications from previous years.

В данном обзоре представлены современные стратегии профилактики и лечения кардиотоксичности, индуцированной наиболее часто применяемыми противоопухолевыми препаратами, такими как антрациклиновые антибиотики, моноклональные антитела, ингибиторы тирозинкиназ. Учитывая обилие и противоречивость данных по способам преодоления кардиотоксичности противоопухолевых препаратов, создание комплекса диагностических мероприятий позволит выявлять наиболее ранние признаки поражения сердца на фоне полихимиотерапии и разработать своевременные профилактические меры с целью предупреждения кардиотоксичности, улучшения качества жизни и прогноза пациентов. В настоящее время доступно большое количество публикаций о распространенности, прогнозировании и профилактике кардиотоксичности у онкологических больных, в том числе о первичной и вторичной профилактике кардиотоксичности. В качестве кардиопротективных агентов чаще всего выступают бета-блокаторы и ингибиторы ангиотензинпревращающего фермента. Имеются данные, свидетельствующие о плохой переносимости лечения этими препаратами больными молодого возраста. Большая часть препаратов обуславливает снижение артериального давления, что может негативно сказываться на самочувствии больных, поскольку большая часть обследуемых пациентов не имеет сопутствующую артериальную гипертензию. Необходимо согласованная работа между кардиологами и онкологами для создания единой терминологии, для обозначения кардиоваскулярных событий и создания регистров, мета-анализов, общепринятых рекомендаций, руководящих принципов по ведению больных с риском развития кардиотоксичности. Материалом исследования послужили опубликованные статьи из базы данных «Scopus», «Pubmed», статьи из журналов «The New England Journal of Medicine», «Annals of Oncology», периодических изданий Российской Федерации за последние 10 лет, также использованы публикации прежних лет.

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