Malek Al-Hawwas1, Despina Tsitlakidou2, Neha Gupta3, Cezar Iliescu4, Mehmet Cilingiroglu5, Konstantinos Marmagkiolis6. 1. University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care System, 4301 W Markham St, Little Rock, AR, 72205, USA. malhawwas@uams.edu. 2. Wayne State University, 42 W Warren Ave, Detroit, MI, 48202, USA. 3. Academy of the Lakes, 2331 Collier Pkwy, Land O, Lakes, FL, 34639, USA. 4. MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. 5. Arkansas Heart Hospital, 1701 South Shackleford Rd., Little Rock, AR, 72211, USA. 6. Florida Hospital, Pepin Heart Institute, 3100 E Fletcher Ave, Tampa, FL, 33613, USA.
Abstract
PURPOSE OF REVIEW: Coronary artery disease and cancer often co-exist. Patients with cancer have been excluded by most major cardiology trials and registries and their management remains largely empiric. Cancer patients experience an approximately 10-times increased mortality compared to the general population. Conservative therapy of ACS in cancer therapy results in 1-year mortality of 74%. This review article aims to describe the mechanisms of acute coronary syndromes in cancer patients, their clinical presentation, and their management. RECENT FINDINGS: Newer studies have shed light on the mechanisms of ACS in cancer patients, which are different and related to the type of malignancy and its associated therapy. Medication-specific coronary effects (vasospasm, endothelial dysfunction, spontaneous thrombosis, accelerated atherosclerosis), radiation vasculitis, cancer cell coronary embolism, and coronary compression from thoracic malignancies are unique ACS mechanisms in cancer patients. Close collaboration between oncologists and cardiologists for thoughtful patient selection and decision making strategies is necessary to provide optimal medical care.
PURPOSE OF REVIEW: Coronary artery disease and cancer often co-exist. Patients with cancer have been excluded by most major cardiology trials and registries and their management remains largely empiric. Cancerpatients experience an approximately 10-times increased mortality compared to the general population. Conservative therapy of ACS in cancer therapy results in 1-year mortality of 74%. This review article aims to describe the mechanisms of acute coronary syndromes in cancerpatients, their clinical presentation, and their management. RECENT FINDINGS: Newer studies have shed light on the mechanisms of ACS in cancerpatients, which are different and related to the type of malignancy and its associated therapy. Medication-specific coronary effects (vasospasm, endothelial dysfunction, spontaneous thrombosis, accelerated atherosclerosis), radiation vasculitis, cancer cell coronary embolism, and coronary compression from thoracic malignancies are unique ACS mechanisms in cancerpatients. Close collaboration between oncologists and cardiologists for thoughtful patient selection and decision making strategies is necessary to provide optimal medical care.
Authors: W J Rogers; J G Canto; C T Lambrew; A J Tiefenbrunn; B Kinkaid; D A Shoultz; P D Frederick; N Every Journal: J Am Coll Cardiol Date: 2000-12 Impact factor: 24.094
Authors: Robert E O'Connor; William Brady; Steven C Brooks; Deborah Diercks; Jonathan Egan; Chris Ghaemmaghami; Venu Menon; Brian J O'Neil; Andrew H Travers; Demetris Yannopoulos Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: Feilong Wang; Rajiv Gulati; Ryan J Lennon; Bradley R Lewis; Jae Park; Gurpreet S Sandhu; R Scott Wright; Amir Lerman; Joerg Herrmann Journal: Mayo Clin Proc Date: 2016-12 Impact factor: 7.616
Authors: C Michael Gibson; Yuri B Pride; Paul D Frederick; Charles V Pollack; John G Canto; Alan J Tiefenbrunn; W Douglas Weaver; Costas T Lambrew; William J French; Eric D Peterson; William J Rogers Journal: Am Heart J Date: 2008-11-01 Impact factor: 4.749
Authors: Matthijs A Velders; Helèn Boden; Sjoerd H Hofma; Susanne Osanto; Bas L van der Hoeven; Anton A C M Heestermans; Suzanne C Cannegieter; J Wouter Jukema; Victor A W M Umans; Martin J Schalij; Adrianus J van Boven Journal: Am J Cardiol Date: 2013-09-21 Impact factor: 2.778
Authors: Nicole Thomason; Dominique J Monlezun; Awad Javaid; Alexandru Filipescu; Efstratios Koutroumpakis; Fisayomi Shobayo; Peter Kim; Juan Lopez-Mattei; Mehmet Cilingiroglu; Gloria Iliescu; Kostas Marmagkiolis; Pedro T Ramirez; Cezar Iliescu Journal: Front Cardiovasc Med Date: 2022-02-14