Management of CAD in Patients with Active Cancer: the Interventional Cardiologists' Perspective

Curr Cardiol Rep. 2017 Jun;19(6):56. doi: 10.1007/s11886-017-0862-x.

Abstract

Purpose of review: Coronary artery disease in patients with active cancer presents particular challenges for clinicians, as optimum management is required in order to treat the underlying malignancy and to reduce morbidity and mortality associated with cardiovascular diseases. Special considerations must be made in respect to either primary or secondary thrombocytopenia, the presence of coagulopathies and the propensity of bleeding, vascular access complications, and increased risk of stent thrombosis.

Recent findings: In presence of acute coronary symptoms, the cardio-oncology team has to make a complex decision between conservative medical management or early angiography (within 24 h) and revascularization. There is a lack of reliable data on the outcomes of patients with active cancer who undergo invasive procedures for the diagnostic and treatment of coronary artery disease. Cardiac catheterization recommendations in cancer patients are being currently elaborated by cardio-oncologists in order to improve the overall survival in cancer patients with coronary artery disease.

Keywords: Cancer; Cardio-oncology; Cardiotoxicity; Coronary artery disease; PCI; Radiation.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization
  • Cardiologists*
  • Conservative Treatment
  • Coronary Angiography
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / therapy*
  • Decision Making*
  • Humans
  • Myocardial Revascularization
  • Neoplasms / complications*