Abstract:
Introduction/Purpose: The mortality rate of cancer patients has been decreasing; however, patients often suffer from cardiac disorders due to chemotherapy or other cancer therapies (e.g., cancer therapy-related cardiovascular toxicity, CVR-CVT). Therefore, the field of cardio-oncology has drawn more attention in recent years. The first European Society of Cardiology (ESC) guideline on cardio-oncology was established in 2022. However, the treatment for CVR-CVT is sometimes difficult due to the complications such as low blood pressure or kidney dysfunction. Ivabradine, a new therapeutic agent that selectively inhibits Iƒ current in the sinoatrial node can be safely used for CVR-CVT patients.
Methods: Six cancer patients were diagnosed with CVR-CVT by the ESC guideline. 5 patients had breast cancer, and 1 patient had colon cancer. All of them presented with HFrEF. Ivabradine was prescribed for these patients following the guideline of the Japanese Circulation Society (JCS). The outcome was compared by evaluating the symptoms, EF, and chest X-ray findings.
Results: All 6 patients tolerated Ivabradine. Four patients died due to the advancement of cancer. The symptoms of heart failure were controlled in all 6 patients, which allowed them to live normal life for at least 7 months. All the patients were able to continue chemotherapy with Ivabradine.
Conclusions: Ivabradine can be used even for advanced cancer patient who wants to continue chemotherapy. Ivabradine may serve as a “key medicine” in treating CVR-CVT.
