Cancer and cardiac diseases are the most prevalent causes of death in most developed countries. Due to the earlier detection and higher effectiveness of treatment, more patients survive the disease and have a long life expectancy. As the post‐cancer population is growing, an increasing number of patients will be diagnosed with sequelae of those therapies, most often affecting the cardiovascular system. Although the risk of cancer recurrence decreases within years, the risk of cardiac complications—for example left ventricle (LV) systolic and diastolic dysfunction, arterial hypertension, arrhythmias, pericardial effusion and premature coronary artery disease remains elevated for decades after the completion of the therapy. The most common anticancer therapies that can cause adverse cardiovascular effects include chemotherapy—in particular anthracyclines, human epidermal growth receptor 2 targeted drugs and radiation therapy. A new field of research, cardio‐oncology, addresses this increasing risk, screening, diagnosis and prevention. This review aims to present the most relevant reports regarding the adverse cardiac effects of oncological therapy, including the most prevalent types of cardiotoxicity, methods of pre‐treatment screening and indications for prevention therapy.

Background: The most reliable care quality indicators for STEMI patients undergoing primary percutaneous coronary intervention (pPCI) include onset-to-door time (OTDT), time from admission to wire crossing and in-hospital mortality.Aims: Our study aimed to evaluate the impact of the COVID-19 pandemic on these selected care quality indicators in pre-pandemic and pandemic groups of STEMI patients.Methods: This single-centre, retrospective study, enrolled 480 STEMI patients, aged 63.59 ± 12.44 years treated with pPCI across two time frames: pre-pandemic (n = 331) and pandemic (n = 149). The evaluation criteria included OTDT, time from admission to PCI-mediated reperfusion, in-hospital mortality, and predictors of time delays.Results: Our study revealed a significant increases in OTDT (median 3 h; IQR 1.5–12.0 vs. median 5 h; IQR 2.0–24.0, p = 0.011) and time from admission to wire crossing (median 92 min; IQR 65.0–187.0 vs. median 115.0; IQR 73.0–233.0, p = 0.025), in the COVID-19 pandemic group of STEMI patients, compared to the pre-pandemic subset. We also observed an increase in in-hospital mortality (7.85% vs. 14.09%, p = 0.033) and incidence of cardiogenic shock/cardiac arrest (16.62% vs. 26.85%, p = 0.009). Additionally, the proportion of patients with prolonged OTDT (24.45% vs. 35.71%, p = 0.019) and extended time from admission to PCI-mediated reperfusion (51.96% vs. 65.77%, p = 0.005) increased during the pandemic period.Conclusions: The study's results indicated prolonged OTDT and admission-to-wire crossing times, increased in-hospital mortality, and the higher frequency of cardiogenic shock/cardiac arrest during the COVID-19 pandemic. These findings demonstrate the negative impact of the pandemic on treatment times and outcomes for patients diagnosed with STEMI.

Background/Objectives: Magnetic resonance imaging (MRI) provides a non-invasive means for a comprehensive assessment of the effect of radiation therapy (RT) on heart function. This study aims to determine RT induced cardiotoxicity in thoracic cancer patients using cardiac MRI. Methods: Cardiac MRI was performed at baseline and at six months post-treatment in patients undergoing standard-of-care RT for lung or esophageal cancers at a single institution. Parameters included regional myocardial strain in the longitudinal, circumferential, and radial directions as well as myocardium T1, T2, and extracellular-volume (ECV) maps. Cardiac segmental doses were extracted from the RT planning scans. The relationship between changes in segmental MRI parameters at six months and segmental heart RT dose were investigated. Results: Twelve patients underwent baseline MRI and four completed the follow-up MRI. Five of the segmental strain parameters showed notable changes between baseline and six-month follow-up. Increased doses in the heart base and apex were associated with moderate-to-large and mild deteriorations, respectively, in strain for all regions. Increased doses in the mid-ventricular regions were associated with improved strain in all regions. The segmental analysis revealed that myocardial regions nurtured by the left coronary artery are more negatively affected by radiation compared to those nurtured by the right coronary artery. Conclusions: Alterations in regional tissue and strain parameters on MRI vary according to local myocardial RT dose, suggesting there may be heterogeneity of radiation sensitivity for the heart substructures and regions. Changes in segmental strain parameters may reflect post-RT cardiac remodeling, but larger confirmatory studies are required.

Introduction: Patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) treated with percutaneous coronary intervention (PCI) are at high risk of bleeding and thromboembolic events. Thus, optimal treatment strategies in this challenging subset have been controversial. Herein, we aim to investigate different triple antithrombotic treatment (TAT) strategies in patients with ACS and AF after PCI. Methods: This was a retrospective, single-center study based on all consecutive patients with the diagnosis of ACS and AF treated with vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOAC) plus dual antiplatelet therapy using a P2Y12 inhibitor (clopidogrel) and aspirin (for 1 to 3 months) and observed for 12 months for major adverse cardiac events (MACE) and major or clinically relevant non-major bleeding incidents. Results: MACE occurred in 26.6% of patients treated with the VKA and 30.9% with NOAC (p = 0.659). Bleeding occurred in 7.8% of patients treated with VKA and 7.4% with NOAC (ns). Conclusions: Among patients with ACS and AF who had undergone PCI, there was no significant difference in the risk of bleeding and ischemic events among those who received TAT with NOAC and VKA.