Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer
Patients with cancer are at increased risk of cardiovascular disease, with a reported prevalence of acute coronary syndrome (ACS) ranging from 3% to 17%. The increased risk of ACS in these patients seems to be due to the complex interaction of shared cardiovascular risk factors, cancer type and stag...
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doaj-a68db83761c340bb97df664729fca8ff2020-11-25T04:07:03ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-0193642364210.3390/jcm9113642Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with CancerValentina Milazzo0Nicola Cosentino1Jeness Campodonico2Claudia Lucci3Daniela Cardinale4Carlo M. Cipolla5Giancarlo Marenzi6Centro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCardioncology Unit, European Institute of Oncology, IRCCS, 20141 Milan, ItalyCardiology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyPatients with cancer are at increased risk of cardiovascular disease, with a reported prevalence of acute coronary syndrome (ACS) ranging from 3% to 17%. The increased risk of ACS in these patients seems to be due to the complex interaction of shared cardiovascular risk factors, cancer type and stage, and chemotherapeutic and radiotherapy regimens. The management of ACS in patients with cancer is a clinical challenge, particularly due to cancer’s unique pathophysiology, which makes it difficult to balance thrombotic and bleeding risks in this specific patient population. In addition, patients with cancer have largely been excluded from ACS trials. Hence, an evidence-based treatment for ACS in this group of patients is unknown and only a limited proportion of them is treated with antiplatelets or invasive revascularization, despite initial reports suggesting their beneficial prognostic effects in cancer patients. Finally, cancer patients experiencing ACS are also at higher risk of in-hospital and long-term mortality as compared to non-cancer patients. In this review, we will provide an overview on the available evidence of the relationship between ACS and cancer, in terms of clinical manifestations, possible underlying mechanisms, and therapeutic and prognostic implications.https://www.mdpi.com/2077-0383/9/11/3642acute coronary syndromecancerchemotherapyprognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Valentina Milazzo Nicola Cosentino Jeness Campodonico Claudia Lucci Daniela Cardinale Carlo M. Cipolla Giancarlo Marenzi |
spellingShingle |
Valentina Milazzo Nicola Cosentino Jeness Campodonico Claudia Lucci Daniela Cardinale Carlo M. Cipolla Giancarlo Marenzi Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer Journal of Clinical Medicine acute coronary syndrome cancer chemotherapy prognosis |
author_facet |
Valentina Milazzo Nicola Cosentino Jeness Campodonico Claudia Lucci Daniela Cardinale Carlo M. Cipolla Giancarlo Marenzi |
author_sort |
Valentina Milazzo |
title |
Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer |
title_short |
Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer |
title_full |
Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer |
title_fullStr |
Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer |
title_full_unstemmed |
Characteristics, Management, and Outcomes of Acute Coronary Syndrome Patients with Cancer |
title_sort |
characteristics, management, and outcomes of acute coronary syndrome patients with cancer |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-11-01 |
description |
Patients with cancer are at increased risk of cardiovascular disease, with a reported prevalence of acute coronary syndrome (ACS) ranging from 3% to 17%. The increased risk of ACS in these patients seems to be due to the complex interaction of shared cardiovascular risk factors, cancer type and stage, and chemotherapeutic and radiotherapy regimens. The management of ACS in patients with cancer is a clinical challenge, particularly due to cancer’s unique pathophysiology, which makes it difficult to balance thrombotic and bleeding risks in this specific patient population. In addition, patients with cancer have largely been excluded from ACS trials. Hence, an evidence-based treatment for ACS in this group of patients is unknown and only a limited proportion of them is treated with antiplatelets or invasive revascularization, despite initial reports suggesting their beneficial prognostic effects in cancer patients. Finally, cancer patients experiencing ACS are also at higher risk of in-hospital and long-term mortality as compared to non-cancer patients. In this review, we will provide an overview on the available evidence of the relationship between ACS and cancer, in terms of clinical manifestations, possible underlying mechanisms, and therapeutic and prognostic implications. |
topic |
acute coronary syndrome cancer chemotherapy prognosis |
url |
https://www.mdpi.com/2077-0383/9/11/3642 |
work_keys_str_mv |
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