Establishment of a cardio-oncology program in the Republic of Kazakhstan
R Abildayeva, A T Tauyekelova, A A MukhamejanovaAbstract
Background/Introduction
Despite well-established heart failure program in our country, structured cardio-oncology pathways and national registries are still lacking. This contributes to delayed recognition of therapy-related cardiovascular toxicity and advanced heart failure development in this group of patients.
Purpose
The aim of this study was to describe the initial set-up of a multidisciplinary cardio-oncology program and characterize patients with a history of cancer therapy and advanced heart failure referred to a specialized heart failure clinic, highlighting opportunities for earlier prevention and monitoring.
Methods
We performed a retrospective study of 45 patients (40 women, 5 men) with chronic heart failure and a prior oncological history followed up in a specialized heart failure clinic between 2018 and 2023. Descriptive statistics were used to summarize clinical characteristics and assess whether cardiovascular risk stratification and cardiotoxicity prevention had been performed before anticancer therapy.
Results
Median age of patients was 56.5 years, 76% of them had breast cancer. All patients had advanced heart failure (stage D; predominantly NYHA III–IV). No patients had documented baseline cardiovascular risk stratification or a structured cardiotoxicity prevention plan prior to initiation of systemic anticancer therapy. Two patients underwent Heart Mate 3 left ventricular assist device as destination therapy, underscoring the limited options once severe heart failure is established. At the time of analysis, 34 out of 45 patients were alive and continue to be followed in a specialized chronic heart failure clinic. Eleven patients died due to complications of chronic heart failure. Among the deceased patients, nine were women with a history of breast and ovarian cancer, and two were men with prostate and colorectal cancer. From 2026 a road map with initiating of cardio-oncology program across the country was launched.
Conclusion(s)
Implementation of structured cardio-oncology pathways, including standardized baseline risk assessment, longitudinal surveillance during and after cancer therapy, and timely cardioprotective treatment, may reduce the rate of terminal heart failure in its late presentation. Coordinated multidisciplinary team and a unified data base platform are essential to improve long-term cardiovascular outcomes in cancer patients.