Recommendation 153: (CCS 2016 Cardio-oncology #2): We recommend that patients who receive potentially cardiotoxic cancer therapy undergo evaluation of LV ejection fraction (LVEF) before initiation of cancer treatments known to cause impairment in LV function (Weak Recommendation, Moderate Quality Evidence).

Recommendation 154: (CCS 2016 Cardio-oncology #5): We suggest that serial use of cardiac biomarkers (e.g., BNP, troponin) be considered for early detection of cardiotoxicity in cancer patients who receive cardiotoxic therapies implicated in the development of LV dysfunction (Weak Recommendation, Moderate Quality Evidence).

Recommendation 155: (CCS 2016 Cardio-oncology #6): We suggest that in patients deemed to be at high risk for cancer treatment-related LV dysfunction, an ACE inhibitor or ARB , and/or beta-blocker, and/or statin be considered to reduce the risk of cardiotoxicity (Weak Recommendation, Moderate Quality Evidence).

Recommendation 156: (CCS 2016 Cardio-oncology #10): We recommend that in cancer patients who develop clinical HF or an asymptomatic decline in LVEF (e.g., > 10% decrease in LVEF from baseline or LVEF < 53%) during or after treatment, investigations, and management follow current CCS guidelines. Other causes of LV dysfunction should be excluded (Strong Recommendation, High Quality Evidence).

Recommendation 157: (CCS 2016 Cardio-oncology #12): We suggest that patients at high risk of cancer therapy related CVD or patients who develop cardiovascular complications during cancer therapy (e.g., > 10% decrease in LVEF from baseline or LVEF < 53%) be referred to a cardio-oncology clinic or practitioner skilled in the management of this patient population, for optimization of cardiac function and consideration of primary or secondary prevention strategies (Weak Recommendation, Low Quality Evidence).