Table 5 Levels of Evidence for methods of prevention of cardiovascular disease related to cancer treatment
From: Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer
| Timing | Intervention | Effect | Level of Evidence | Reference |
|---|---|---|---|---|
| Pre-treatment | Use of predictive models for future CVD | Risk groups to predict rate of cardiac events during 3 year follow-up after curative (HER2+) BC treatment | 2b | [15] |
| During treatment | ACEi/ARB | Mean difference in delta LVEF −2.36% in pts. with early HER2+/− BC | 1a | [28] |
| Beta-blocker | 2,6% lower incidence of LVEF < 50% compared to placebo, NNT 38 | 1a | [29] | |
| Statins | No difference in LVEF < 50% | 1b | [39] | |
| Aspirin/anticoagulants | n.a. | n.a. | ||
| Other drugs; dexrazoxane | Reduces risk of CHF and cardiac events | 1a | [40] | |
| Other drugs; sildenafil | No difference LVEF-declines | 1b | [42] | |
| Smoking cessation | Circumstantial: smokers increased reisk for cardiac toxicity related to radiotherapy | n.a. | ||
| Weight loss | Circumstantial: reduction non-BC mortality in BC survivors | n.a. | ||
| Physical exercise | Hypothesis generating for ongoing RCT’s | 5 | ||
| Post treatment | Primary prevention | Indirect evidence from general population | n.a. |