Strategies to Prevent Anthracycline-Related Congestive Heart Failure in Survivors of Childhood Cancer

Table 1

Strategies for prevention of anthracycline-related congestive heart failure.

Type of prevention	Definition	Examples
Primary prevention	Preventing the initial development of a disease	(i) Limit lifetime anthracycline exposure; (ii) Less cardiotoxic analogues; (a) Epirubicin; (b) Idarubicin; (c) Mitoxantrone; (iii) Alternative drug administration schedules; (a) Bolus versus continuous infusion; (iv) Cardioprotectants; (a) Dexrazoxane
Secondary prevention	Prevention of disease before onset of signs and symptoms of illness	(i) Adoption of healthy lifestyle; (ii) Aggressive management of modifiable risk factors (hypertension, diabetes); (iii) Pharmacologic intervention; (a) ACE inhibitors; (b) β blockers
Tertiary prevention	Reducing the impact of the disease	(i) Pharmacologic intervention; (a) ACE inhibitors; (b) β blockers