Expert Consensus of the Russian Society of Cardiology, the Society of Heart Failure Specialists, the Russian Association of Oncologists, and the Eurasian Association of Cardio-Oncologists. “Cardioprotection 2025: Modern Approaches to Preventing Cardiovasculatoxicity in Antitumor Therapy”. Part II. Primary Prevention of Cardiovasculatoxicity: a Strategy for Protecting the Myocardium and Vessels

The aim is to present expert-agreed guidelines for the primary prevention of cardiovasculotoxicity of anticancer therapy as part of the Cardioprotection 2025 Consensus of the Russian Society of Cardiology, the Society of Heart Failure Specialists, the Russian Association of Oncologists, and the Eurasian Association of Cardio-Oncologists. The second part of the Consensus focuses on strategies for protecting the myocardium and blood vessels before or at early stages of anticancer treatment. The document addresses the key principles of primary prevention of cardiovasculotoxicity: interdisciplinary collaboration between cardiologists and oncologists at the stage of treatment scheduling, the possibility of managing modifiable risk factors, pharmacological cardioprotection, approaches to preventive screening (including clinical evaluation, biomarkers, and imaging), non-pharmacological prevention (physical activity, nutritional status correction, artificial intelligence, and digital monitoring management), and specific features of prophylaxis in the treatment with key anticancer drug classes (anthracyclines, HER2-targeted agents, tyrosine kinase inhibitors, anti-VEGF agents, immune checkpoint inhibitors). This document aims to optimize patient management to reduce the risk of cardiovascular complications during anticancer therapy.