Cardiovascular effects of bevacizumab include:
(1) decreased in left ventricular ejection fraction (LVEF)
(2) cardiac arrhythmia
(3) hypertension
(4) acute coronary syndrome and/or cardiac enzyme elevations (with or without arterial thromboembolism)
(5) ECG changes
Bevacizumab therapy is independently associated with an increased risk for heart failure. The risk is seen with both low dose and high dose regimens.
Risk factors for cardiac toxicity and/or heart failure in a patient receiving bevacizumab therapy:
(1) history of anthracycline therapy
(2) left chest wall irradiation
(3) history of myocardial infarction
If bevacizumab-associated cardiac injury is suspected then:
(1) discontinue bevacizumab therapy
(2) refer the patient to a cardiologist
The half-life of bevacizumab is 3 weeks so it may take up to 3 months to completely clear it from the body.
