CML Horizons -Cardiovascular risks for CML patients on tkis

Hi All,
If you look at the CML Horizons 2024 Videos etc posted here in "Home" you will come across a pdf /slide presentation presentation on Day 2 from an author Natalia Lopina on Cardio risk factors for CML patients on tki s.
In fact there is a full journal article that may be accessed titled:
"A New Paradigm of Cardio-Hematological Monitoring in Chronic Myeloid Leukemia Patients Treated With Tyrosine Kinase Inhibitors"by N.Lopina et al in Cureus 2022 Jun 14(6)
One of the key statements for me in the introduction section of the paper is -"Lesions of the cardio-vascular system develop with TKI administration due to the effect of these drugs on vessels,metabolism,and myocardium" (Google Cardio-hematological monitoring in CML )
So it looks as if long term the use of tkis do produce cardiotoxicity.
However as we progress in age apparently a significant proportion of the general population develop abnormal heart rhythms or atrial fibrilation (Afib) or forms of arythmia-whether the use of tkis will hasten the onset of such conditions is still open to debate.
Some 17 years ago when going on what was then Glivec first of all I asked my specialist whether this tki (only this one available then I recall?) had an effect on the heart-he said not unless you already have a heart condition and if this is the case then it might make your condition more dangerous.
The article indicates that imatinib is probably far safer on the heart than nilotinib;we know already that ponatinib is in some patients a significant vascular risk with a black box warning in place.
Patients with heart rhythms are at risk of developing a stroke so are normally placed on a blood thinner/anti coagulant such as warfarin previously but now edoxaban or similar.Side effects are are increased risk of bleeding so for CML patients eye bleeds from imatinib may be more severe and therefore the interaction between the tki and the anti coagulant needs to be monitored.
If you are concerned about the long term effects of a tki such as developing a cardiac issue or if you already have a cardiac issue then the paper and /or the slide presentation will be of interest.
Of interest is the comment by the author that some suggest that statins be prescribed to all CML patients as they reduce cardiovascular risk and and also assist in achieving deeper molecular response.
Finally the author suggests that before going on a particular tki that cardio risk is assessed and during treatment there should be monitoring especially of older age groups-by periodic ECGs for instance and/or an echo cardiogram(heart scan) every year or so if issues are detected.
Best wishes
John