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REVIEW ARTICLE

Cardiovascular complications associated with PARP inhibitors in ovarian cancer treatment: A review

Chang Liu1,2 ,  Senwei Jiang3*
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1 Department of Cardiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
2 Department of Cardiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
3 Department of Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
CP, 025350053 https://doi.org/10.36922/CP025350053
Received: 30 August 2025 | Revised: 1 December 2025 | Accepted: 10 February 2026 | Published online: 22 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) have transformed ovarian cancer treatment, particularly in patients with BRCA mutations, but are associated with distinct cardiovascular complications. This review synthesizes current evidence on PARPi-associated major adverse cardiovascular events (MACEs), hypertension, and thromboembolic events. Among PARPi, niraparib demonstrates the highest cardiovascular risk, with significant hypertension (any-grade: up to 17%; high-grade: up to 5%) and MACEs incidence, attributed to its off-target inhibition of neurotransmitter transporters. Olaparib exhibits a more variable safety profile, with lower MACE risk as monotherapy but increased hypertension in combination regimens. Rucaparib and veliparib show comparatively favorable cardiovascular profiles. Hypertension is the most frequent event, managed conventionally with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, calcium channel blockers, or dose modification. Thromboembolic risks remain low overall but may escalate with specific combinations. Proactive, agent-specific risk assessment and management are essential to optimize the therapeutic index of PARP inhibitors, and future research should focus on validating predictive biomarkers and exploring cardioprotective strategies.

Keywords
Poly (adenosine diphosphate-ribose) polymerase inhibitors
Ovarian cancer
Cardiovascular complications
Major adverse cardiovascular events
Thromboembolic events
Hypertension
Funding
This study was supported by the Guangzhou Municipal Science and Technology Program (Grant no. 2023A04J1261).
Conflict of interest
The authors declare they have no competing interests.
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