ArticleInternal medicine journal2025
Australia and New Zealand consensus statement on the cardiovascular management of patients with chronic lymphocytic leukaemia treated with Bruton's tyrosine kinase inhibitors.
Article in Internal medicine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Estimated cardiac deaths associated with treating chronic lymphocytic leukemia with ibrutinib versus zanubrutinib in the United States.Future oncology (London, England) · 2026Article
- Addressing cardiovascular toxicities of Bruton tyrosine kinase inhibitors in chronic lymphocytic leukaemia: practical recommendations for haematologists in central and eastern Europe.Cardio-oncology (London, England) · 2025Article
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10 authors.
Funding
Abstract
backgroundBruton's tyrosine kinase inhibitors (BTKi) reduce mortality and morbidity in chronic lymphocytic leukaemia (CLL) but have an association with cardiotoxicities, including hypertension, atrial fibrillation (AF), ventricular arrhythmias (VA) and bleeding. There is currently no specific advice for Australian and New Zealand clinicians.
aimIn this paper, we aim to provide evidence-based recommendations for risk assessment, monitoring and managing cardiovascular (CV) toxicity to optimise patient outcomes.
methodsA multidisciplinary roundtable was held on 21 August 2023 to discuss clinical evidence and derive consensus recommendations, which were graded according to class and level of evidence.
resultsBaseline CV risk assessment, including patient history, blood pressure (BP), pulse and ECG, is recommended in all patients before starting a BTKi. Management and monitoring requirements should reflect the patient's risk status. A target BP of 140/90 mmHg should be achieved (or 130/80 mmHg in high-risk patients or those with CV disease). In patients with pre-existing AF, closer monitoring is recommended in consultation with cardiology. Oral anticoagulation is generally warranted in patients with a CHA2DS2-VASc score of ≥2 in males or ≥3 in females. BTKi should be withheld for 3 days before and after a minor procedure and 7 days prior to or post a major procedure. Due to the risk of VA and sudden death, BTKi is generally contraindicated in patients with previous VA, severe or uncontrolled heart failure or hypertension. Multidisciplinary care aims to minimise complications and improve treatment outcomes.
conclusionFurther research should be directed at validating CV screening tools and measuring outcomes based on these recommendations.
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