Introduction: The evolving field of oncology necessitates effective management of cancer-related cardiovascular diseases. In Saudi Arabia, the incidence of cancer is rising, and there is a critical need for cardio-oncology services to address cancer treatment-related cardiovascular toxicity. This study aimed to evaluate the knowledge and practices of healthcare providers (HCPs) in Saudi Arabia regarding cardio-oncology. Methods: A cross-sectional study was conducted from January 2024 to April 2024 using an online survey targeting cardiologists, oncologists, and clinical pharmacists. The survey assessed demographics, perceptions of cardio-oncology, availability of services, and current practices. Data were analyzed using descriptive statistics, chi-squared tests, and bivariate analyses. Results: The survey received responses from 116 HCPs, including cardiologists (63.79%), oncologists (23.28%), and clinical pharmacists (12.93%). Most participants had over six years of experience, and only one had formal cardio-oncology training. While 84.48% recognized the importance of managing cardiac complications in cancer patients, only 42.24% were familiar with existing guidelines. Limited training programs and institutional resources were significant barriers to implementing cardio-oncology services. Despite agreement on the need for cardiotoxicity management, only one-third recommended cardioprotective agents as standard care. Conclusion: There is a notable deficiency in formal training and resources for cardio-oncology in Saudi Arabia. To bridge this gap, integrating cardio-oncology into training programs, establishing institutional guidelines, and adopting multidisciplinary care models are crucial. These measures will enhance the quality of care for cancer patients and improve their cardiovascular outcomes.
Background/Objectives: Apixaban is favored over warfarin for atrial fibrillation (Afib) and venous thromboembolism (VTE) due to its effectiveness, safety, and lack of routine monitoring. However, managing anticoagulation in hospitalized patients with acute kidney injury (AKI) is challenging due to altered pharmacokinetics and limited safety data. This study assesses the safety and efficacy of apixaban versus warfarin in these patients. Methods: This retrospective chart review at King Abdulaziz Medical City in Riyadh included adult patients (≥18 years) with AKI, as defined by the Kidney Disease Improving Global Outcome (KDIGO) guideline. Primary outcomes were rates of major and minor bleeding within 30 days, as defined by the International Society on Thrombosis and Haemostasis (ISTH), and thrombotic events. Secondary outcomes included 30-day rates of all-cause mortality and hospital readmissions. Results: Among 513 patients, 294 received apixaban and 219 received warfarin. Major bleeding within 30 days was significantly lower in the apixaban group (3.4%) compared to warfarin (7.3%) (p = 0.0461). Minor bleeding rates were similar (6.5% apixaban vs. 5.5% warfarin; p = 0.616). Thrombotic events occurred in 6.8% of patients, with no significant difference between apixaban (6.5%) and warfarin (7.3%) (p = 0.739). Mortality rates were 8.0%, with no significant difference (8.8% apixaban vs. 6.8% warfarin; p = 0.3846). Readmission rates were comparable (38.8% for apixaban vs. 39.7% for warfarin; p = 0.9499). Conclusions: In hospitalized AKI patients, apixaban was associated with a lower major bleeding risk compared to warfarin, with similar rates of thrombotic events, mortality, and readmissions, suggesting apixaban may be a safer option, warranting further research.
26 May 2024 in JACCP: Journal of the American College of Clinical Pharmacy
Introduction: The evolving field of oncology necessitates effective management of cancer-related cardiovascular diseases. In Saudi Arabia, the incidence of cancer is rising, and there is a critical need for cardio-oncology services to address cancer treatment-related cardiovascular toxicity. This study aimed to evaluate the knowledge and practices of healthcare providers (HCPs) in Saudi Arabia regarding cardio-oncology. Methods: A cross-sectional study was conducted from January to April 2024 using an online survey targeting cardiologists, oncologists, and clinical pharmacists. The survey assessed demographics, perceptions of cardio-oncology, availability of services, and current practices. Data were analyzed using descriptive statistics, chi-squared tests, and bivariate analyses. Results: The survey received responses from 116 HCPs, including cardiologists (63.79%), oncologists (23.28%), and clinical pharmacists (12.93%). Most participants had over six years of experience, and only one had formal cardio-oncology training. While 84.48% recognized the importance of managing cardiac complications in cancer patients, only 42.24% were familiar with existing guidelines. Limited training programs and institutional resources were significant barriers to implementing cardio-oncology services. Despite agreement on the need for cardiotoxicity management, only one-third recommended cardioprotective agents as standard care. Conclusion: There is a notable deficiency in formal training and resources for cardio-oncology in Saudi Arabia. To bridge this gap, integrating cardio-oncology into training programs, establishing institutional guidelines, and adopting multidisciplinary care models are crucial. These measures will enhance the quality of care for cancer patients and improve their cardiovascular outcomes.