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Article ; Online: Direct Oral Anticoagulants in Patients With Cancer and Nonvalvular Atrial Fibrillation.

Davis, Margot K / Lim, Howard / Lee, Agnes Y Y

JACC. CardioOncology

2021 Volume 3, Issue 3, Page(s) 425–427

Language	English
Publishing date	2021-09-21
Publishing country	United States
Document type	Editorial
ISSN	2666-0873
ISSN (online)	2666-0873
DOI	10.1016/j.jaccao.2021.07.003
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Article ; Online: An Urgent Need for Data to Drive Decision Making: Rationale for the Canadian Registry for Amyloidosis Research.

Davis, Margot K / Fine, Nowell M

The Canadian journal of cardiology

2019 Volume 36, Issue 3, Page(s) 447–449

Abstract: Recent developments in cardiac amyloidosis have raised awareness of the disease and have advanced diagnostic and treatment strategies. Novel therapies may vastly improve the prognosis of the disease but will be associated with significant costs. Data are ...

Abstract	Recent developments in cardiac amyloidosis have raised awareness of the disease and have advanced diagnostic and treatment strategies. Novel therapies may vastly improve the prognosis of the disease but will be associated with significant costs. Data are needed to inform clinical decisions and to drive resource allocation within the health care system. Many aspects of disease management are unlikely to be addressed by clinical trials and are better suited to nonrandomized cohort studies, but the limited numbers of patients in any single centre present barriers to high-quality observational research. Disease registries offer opportunities to assemble large numbers of patients from multiple institutions for adequately powered observational studies, to recruit patients for randomized clinical trials; to provide real-world effectiveness and safety data, to study cost-effectiveness of novel therapies, and to engage patients in the collection of patient-reported outcome data. Existing amyloidosis registries have limitations. Canada is an ideal setting for a national amyloidosis registry, with ethnic diversity, relatively few academic centres, access to advanced diagnostic and therapeutic options, and a track record of collaboration among institutions. The Canadian Registry for Amyloidosis Research aims to capitalize on this opportunity and provide high-quality data to inform clinical practice and health care policy in Canada and beyond.
MeSH term(s)	Amyloidosis/therapy ; Biomedical Research ; Canada ; Cardiomyopathies/therapy ; Clinical Decision-Making ; Clinical Trials as Topic ; Humans ; Registries
Language	English
Publishing date	2019-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2019.12.005
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Article ; Online: Effect of long-term tafamidis treatment on health-related quality of life in patients with transthyretin amyloid cardiomyopathy.

Grogan, Martha / Davis, Margot K / Crespo-Leiro, Maria G / Sultan, Marla B / Gundapaneni, Balarama / Stedile Angeli, Franca / Hanna, Mazen

European journal of heart failure

2024

Abstract: Aims: To evaluate the effect of long-term tafamidis treatment on health-related quality of life (HRQoL) in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) enrolled in the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) ... ...

Abstract	Aims: To evaluate the effect of long-term tafamidis treatment on health-related quality of life (HRQoL) in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) enrolled in the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) and long-term extension (LTE) study. Methods and results: We examined change from baseline in Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS) and clinical summary (KCCQ-CS) scores in patients who received tafamidis meglumine 80 mg for 30 months in ATTR-ACT and tafamidis (meglumine 80 mg or bioequivalent free acid 61 mg) for 30 months in the LTE study, and in patients who received placebo for 30 months in ATTR-ACT and tafamidis for 30 months in the LTE study. In ATTR-ACT, 176 and 177 patients were randomized to tafamidis 80 mg and placebo, respectively. Patients who continuously received tafamidis had a 6- to 7-point reduction in least squares (LS) mean (standard error) KCCQ-OS and KCCQ-CS scores at month 30 (-6.25 [1.53] and -7.48 [1.39]), with little or no further decline over the next 30 months (-5.92 [1.77] and -9.21 [1.88] at month 60). Patients who received placebo in ATTR-ACT had a 20-point reduction in LS mean KCCQ-OS and KCCQ-CS scores at month 30 (-19.60 [1.94] and -19.90 [2.01]), but the decline slowed after initiating tafamidis (-24.70 [3.04] and -25.30 [3.36] at month 60). Conclusion: Tafamidis reduced HRQoL decline in patients with ATTR-CM. Patients continuously treated with tafamidis for 60 months demonstrated stabilized HRQoL. In patients who initially received placebo in ATTR-ACT, tafamidis reduced the decline in HRQoL during the LTE study.
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1002/ejhf.3190
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Zs.A 5299: Show issues

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Article ; Online: Statins in Cardio-oncology: Holy Grail or Epiphenomenon.

Davis, Margot K / Virani, Sean A

The Canadian journal of cardiology

2018 Volume 35, Issue 2, Page(s) 142–144

MeSH term(s)	Breast Neoplasms ; Heart ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Medical Oncology ; Trastuzumab
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Trastuzumab (P188ANX8CK)
Language	English
Publishing date	2018-12-26
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2018.12.026
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Article ; Online: Exercise Training for Cancer Survivors.

Tong, Calvin K W / Lau, Benny / Davis, Margot K

Current treatment options in oncology

2020 Volume 21, Issue 7, Page(s) 53

Abstract: Opinion statement: Cardiovascular diseases are a common cause of morbidity and mortality in cancer survivors. Furthermore, some cancer therapies are now being increasingly recognized to have negative cardiovascular effects, or cardiotoxicity. Exercise ... ...

Abstract	Opinion statement: Cardiovascular diseases are a common cause of morbidity and mortality in cancer survivors. Furthermore, some cancer therapies are now being increasingly recognized to have negative cardiovascular effects, or cardiotoxicity. Exercise therapy has been found to improve cardiorespiratory fitness in patients with cancer as well as attenuate the cardiotoxic effects of cancer therapy. It is the centerpiece for cardiac and pulmonary rehabilitation programs. It is also an important component in cardio-oncology rehabilitation. Exercise is generally safe, and its benefit is observed when started as soon as the diagnosis of cancer and throughout cancer survivorship.
MeSH term(s)	Cancer Survivors ; Cardiorespiratory Fitness ; Cardiotoxicity ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Cardiovascular Diseases/therapy ; Disease Management ; Exercise ; Exercise Therapy ; Health Impact Assessment ; Humans ; Neoplasms/complications ; Neoplasms/rehabilitation ; Neoplasms/therapy ; Outcome Assessment, Health Care
Language	English
Publishing date	2020-05-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-020-00752-w
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Zs.A 5523: Show issues

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Article ; Online: Management strategies and clinical outcomes in breast cancer patients who develop left ventricular dysfunction during trastuzumab therapy.

Yao, Ren Jie Robert / Gibson, Jordan / Simmons, Christine / Davis, Margot K

Cardio-oncology (London, England)

2021 Volume 7, Issue 1, Page(s) 12

Abstract: Background: Trastuzumab reduces risk of breast cancer recurrence but carries risk of cardiotoxicity that may be reversible upon treatment cessation and institution of left ventricular (LV) enhancement therapies (LVETx). We assessed management patterns ... ...

Abstract	Background: Trastuzumab reduces risk of breast cancer recurrence but carries risk of cardiotoxicity that may be reversible upon treatment cessation and institution of left ventricular (LV) enhancement therapies (LVETx). We assessed management patterns of trastuzumab-induced cardiotoxicity (TIC) in a contemporary real-world setting. Methods: We reviewed charts of all breast cancer patients who received adjuvant trastuzumab in British Columbia between January 2010 and December 2013, spanning the opening of a cardio-oncology clinic. LV dysfunction (LVD) was classified as minimal (LVEF nadir 45-49%), mild (40-44%) or moderate-severe (< 40%). Charts were reviewed for baseline characteristics, management strategies, and outcomes. Multivariable analysis was performed to identify patient characteristics associated with trastuzumab completion and cardiology referral. Results: Of 967 patients receiving trastuzumab, 171 (17.7%) developed LVD, including 114 patients (11.8%) with LVEF declines of ≥10 to < 50%. Proportions of patients receiving cardiology referrals and LVETx increased and wait times to consultation decreased after a dedicated cardio-oncology clinic opened. LVETx was used more frequently in patients with moderate-severe LVD compared to minimal or mild LVD. Factors associated with completion of trastuzumab included mastectomy (OR 5.1, 95% CI 1.1-23.0) and proximity to quaternary care centre (OR 7.7, 95% CI 2.2-26.2). Moderate-severe LVD was associated with a lower probability of completing trastuzumab (OR 0.07 vs. minimal LVD, 95% CI 0.01-0.74). Factors associated with cardiology referral included heart failure symptoms (OR 8.0, 95% CI 1.5-42.9), proximity to quaternary care centre (OR 6.8, 95% CI 1.3-34.2), later year of cancer diagnosis (OR 2.4 per year, 95% CI 1.4-4.3), node-positive disease (OR 0.18, 95% CI 0.06-0.56), mastectomy (OR 0.05, 95% CI 0.01-0.52), and minimal LVD (OR 0.14, 95% CI 0.05-0.46). LVEF recovered to > 50% in 90.7% of patients. Conclusions: Management strategies in patients with TIC are associated with cancer characteristics and severity of cardiotoxicity. Access to dedicated cardio-oncology clinics may facilitate optimal care of this complex patient population.
Language	English
Publishing date	2021-03-26
Publishing country	England
Document type	Journal Article
ISSN	2057-3804
ISSN (online)	2057-3804
DOI	10.1186/s40959-021-00099-7
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Article ; Online: RARG S427L attenuates the DNA repair response to doxorubicin in induced pluripotent stem cell-derived cardiomyocytes.

Huang, Haojun / Christidi, Effimia / Shafaattalab, Sanam / Davis, Margot K / Tibbits, Glen F / Brunham, Liam R

Stem cell reports

2022 Volume 17, Issue 4, Page(s) 756–765

Abstract: Doxorubicin is a commonly used chemotherapeutic drug, but its use is limited by doxorubicin-induced cardiotoxicity (DIC), which can lead to irreversible heart failure and death. A missense variant rs2229774 (p.S427L) in the retinoic acid receptor gamma ( ... ...

Abstract	Doxorubicin is a commonly used chemotherapeutic drug, but its use is limited by doxorubicin-induced cardiotoxicity (DIC), which can lead to irreversible heart failure and death. A missense variant rs2229774 (p.S427L) in the retinoic acid receptor gamma (RARG) gene is associated with increased susceptibility to DIC, but the precise mechanism underlying this association is incompletely understood. We performed molecular dynamic simulations to determine the effect of this variant on RARG structure and then validated these predictions using CRISPR-Cas9-genome-edited, induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). We found that this variant leads to reduced activation of its target genes in response to doxorubicin, including gene pathways involved in DNA repair and consequently an inability to mediate DNA repair after exposure to doxorubicin. Our findings establish a role of RARG p.S427L in attenuating DNA repair in DIC and provide insight into the pathogenesis of this cardiotoxic effect.
MeSH term(s)	Antibiotics, Antineoplastic/pharmacology ; Cardiotoxicity ; DNA Repair ; Doxorubicin/pharmacology ; Humans ; Induced Pluripotent Stem Cells ; Myocytes, Cardiac/metabolism
Chemical Substances	Antibiotics, Antineoplastic ; Doxorubicin (80168379AG)
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2720528-9
ISSN	2213-6711 ; 2213-6711
ISSN (online)	2213-6711
ISSN	2213-6711
DOI	10.1016/j.stemcr.2022.03.002
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Article ; Online: Cardiac Amyloidosis: We've Come So Far, It's Only the Beginning.

Fine, Nowell M / Falk, Rodney H / Davis, Margot K

The Canadian journal of cardiology

2019 Volume 36, Issue 3, Page(s) 319–321

MeSH term(s)	Amyloidosis/diagnosis ; Amyloidosis/therapy ; Cardiomyopathies/diagnosis ; Cardiomyopathies/therapy ; Humans
Language	English
Publishing date	2019-12-12
Publishing country	England
Document type	Editorial
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2019.12.009
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Article ; Online: Routine Prophylactic Cardioprotective Therapy Should Not Be Given to All Recipients of Potentially Cardiotoxic Cancer Chemotherapy.

Davis, Margot K / Virani, Sean A

The Canadian journal of cardiology

2016 Volume 32, Issue 7, Page(s) 926–930

Abstract: With growing recognition of the associations between cancer therapy and cardiotoxicity, attention has increasingly focused on the prevention of cancer therapy-related cardiovascular disease. Various strategies for cardioprotection have been proposed, ... ...

Abstract	With growing recognition of the associations between cancer therapy and cardiotoxicity, attention has increasingly focused on the prevention of cancer therapy-related cardiovascular disease. Various strategies for cardioprotection have been proposed, including routine administration of therapies such as inhibitors of the renin-angiotensin-aldosterone system and β-blockers. We argue this approach is unsupported by the evidence and will be associated with a high likelihood of adverse effects. We highlight alternate strategies for managing this emerging issue, which focus on a targeted approach to primary prevention driven by early identification of cardiotoxicity and selective prophylaxis of patients at increased risk for developing cardiotoxicity.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Cardiotonic Agents/therapeutic use ; Cardiotoxicity/prevention & control ; Clinical Trials as Topic ; Diagnostic Imaging ; Early Diagnosis ; Humans ; Neoplasms/drug therapy ; Patient Selection ; Primary Prevention ; Risk Assessment ; Secondary Prevention ; Ventricular Dysfunction, Left/diagnosis
Chemical Substances	Antineoplastic Agents ; Cardiotonic Agents
Language	English
Publishing date	2016-07
Publishing country	England
Document type	Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2016.02.061
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Article: Exercise Prevention of Cardiovascular Disease in Breast Cancer Survivors.

Kirkham, Amy A / Davis, Margot K

Journal of oncology

2015 Volume 2015, Page(s) 917606

Abstract: Thanks to increasingly effective treatment, breast cancer mortality rates have significantly declined over the past few decades. Following the increase in life expectancy of women diagnosed with breast cancer, it has been recognized that these women are ... ...

Abstract	Thanks to increasingly effective treatment, breast cancer mortality rates have significantly declined over the past few decades. Following the increase in life expectancy of women diagnosed with breast cancer, it has been recognized that these women are at an elevated risk for cardiovascular disease due in part to the cardiotoxic side effects of treatment. This paper reviews evidence for the role of exercise in prevention of cardiovascular toxicity associated with chemotherapy used in breast cancer, and in modifying cardiovascular risk factors in breast cancer survivors. There is growing evidence indicating that the primary mechanism for this protective effect appears to be improved antioxidant capacity in the heart and vasculature and subsequent reduction of treatment-related oxidative stress in these structures. Further clinical research is needed to determine whether exercise is a feasible and effective nonpharmacological treatment to reduce cardiovascular morbidity and mortality in breast cancer survivors, to identify the cancer therapies for which it is effective, and to determine the optimal exercise dose. Safe and noninvasive measures that are sensitive to changes in cardiovascular function are required to answer these questions in patient populations. Cardiac strain, endothelial function, and cardiac biomarkers are suggested outcome measures for clinical research in this field.
Language	English
Publishing date	2015-08-03
Publishing country	Egypt
Document type	Journal Article ; Review
ZDB-ID	2461349-6
ISSN	1687-8469 ; 1687-8450
ISSN (online)	1687-8469
ISSN	1687-8450
DOI	10.1155/2015/917606
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