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

Dana Elena Giza1, Kostas Marmagkiolis2, Elie Mouhayar1

  • 1Department of Cardiology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.

Current Cardiology Reports
|May 10, 2017
PubMed

Insights

Managing coronary artery disease in active cancer patients is complex. Cardio-oncology teams face challenges balancing cancer treatment with cardiovascular care, especially regarding bleeding risks and invasive procedures.

Area of Science:

  • Cardio-oncology
  • Cardiovascular Medicine
  • Oncology

Background:

  • Coronary artery disease (CAD) in active cancer patients presents unique clinical challenges.
  • Optimal management requires balancing malignancy treatment with cardiovascular disease (CVD) risk reduction.
  • Considerations include thrombocytopenia, coagulopathies, bleeding propensity, vascular access, and stent thrombosis risk.

Purpose of the Study:

  • To review the challenges and considerations in managing CAD in patients with active cancer.
  • To highlight the complexities in decision-making for acute coronary symptoms in this population.
  • To inform the development of cardiac catheterization recommendations for cancer patients.

Main Methods:

  • Review of current clinical challenges and decision-making processes in cardio-oncology.
  • Analysis of the need for specialized guidelines for invasive cardiac procedures in cancer patients.
  • Synthesis of existing knowledge on managing CAD comorbidities in oncology settings.

Main Results:

  • Management decisions for acute coronary symptoms involve balancing conservative care versus early angiography and revascularization.
  • There is a significant lack of robust data on outcomes for cancer patients undergoing invasive cardiac procedures.
  • Cardio-oncologists are developing specific recommendations for cardiac catheterization in cancer patients.

Conclusions:

  • Effective management of CAD in active cancer patients necessitates a multidisciplinary approach.
  • Further research is crucial to establish evidence-based guidelines for invasive cardiac procedures in this vulnerable population.
  • Improved strategies aim to enhance overall survival for cancer patients with concurrent CAD.
Abstract

Keywords:
CancerCardio-oncologyCardiotoxicityCoronary artery diseasePCIRadiation

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