{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:02:17Z","timestamp":1789765337691,"version":"4.0.1"},"reference-count":77,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardio\u2010oncology is a clinical discipline focused primarily on the early detection of anticancer therapy\u2013related cardiomyopathy. However, there is growing evidence that the direct adverse consequences extend beyond the myocardium to affect the vasculature, but this evidence remains limited. In addition, there remains a paucity of clinically based strategies for monitoring vascular toxicity in these patients. Importantly, arterial stiffness is increasingly recognized as a surrogate end point for cardiovascular disease and may be an important vascular outcome to consider. Therefore, the aim of this systematic review and meta\u2010analysis was to summarize evidence of increased arterial stiffening with anticancer therapy and evaluate the effect of treatment modifiers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 19 longitudinal and cross\u2010sectional studies that evaluated arterial stiffness both during and following anticancer therapy were identified using multiple databases. Two separate analyses were performed: baseline to follow\u2010up (12 studies) and control versus patient groups (10 studies). Subgroup analysis evaluated whether stiffness differed as a function of treatment type and follow\u2010up time. Standard mean differences and mean differences were calculated using random effect models. Significant increases in arterial stiffness were identified from baseline to follow\u2010up (standard mean difference, 0.890; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.448\u20131.332;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001; mean difference, 1.505; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.789\u20132.221;\n                      <jats:italic>P<\/jats:italic>\n                      \u22640.0001) and in patient versus control groups (standard mean difference, 0.860; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.402\u20131.318;\n                      <jats:italic>P<\/jats:italic>\n                      =0.0002; mean difference, 1.437; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.426\u20132.448;\n                      <jats:italic>P<\/jats:italic>\n                      =0.0052). Subgroup analysis indicated differences in arterial stiffness between anthracycline\u2010based and non\u2010anthracycline\u2010based therapies (standard mean difference, 0.20; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.001\u20130.41;\n                      <jats:italic>P<\/jats:italic>\n                      =0.048), but not follow\u2010up time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Significant arterial stiffening occurs following anticancer therapy. Our findings support the use of arterial stiffness as part of a targeted vascular imaging strategy for the identification of early cardiovascular injury during treatment and for the detection of long\u2010term cardiovascular injury into survivorship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.015598","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T05:28:38Z","timestamp":1594358918000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Anticancer Therapy\u2013Related Increases in Arterial Stiffness: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"9","author":[{"given":"Shannon K.","family":"Parr","sequence":"first","affiliation":[{"name":"Department of Kinesiology College of Health and Human Sciences Kansas State University Manhattan KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Statistics Kansas State University Manhattan KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keri L.","family":"Schadler","sequence":"additional","affiliation":[{"name":"Division of Pediatrics Department of Pediatrics The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan C.","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Department of Clinical Cancer Prevention and Department of Cardiology The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine C.","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Food, Nutrition, Dietetics, Health Kansas State University Manhattan KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1837-2342","authenticated-orcid":false,"given":"Carl J.","family":"Ade","sequence":"additional","affiliation":[{"name":"Department of Kinesiology College of Health and Human Sciences Kansas State University Manhattan KS"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5603\/KP.2013.0154"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00005.2018"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003319713498298"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00394.2018"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.5400"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002661"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000641"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-007-0010-y"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.37.5.1236"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.555235"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.886655"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.061"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.07.012"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000550"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.11.017"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000133187.74800.b9"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl254"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(02)02962-X"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/95.2.67"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000523"},{"key":"e_1_3_2_24_2","volume-title":"The Standardized Mean Difference Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2011","unstructured":"Higgins JPT, Green S. 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