Cancer-Associated Atherothrombosis: The Challenge

Area of Science:

• Cardiovascular Medicine
• Oncology
• Thrombosis Research

Background:

• Venous thrombosis is a known paraneoplastic syndrome associated with malignancy.
• Arterial thromboembolism (ATE) is increasingly recognized as a paraneoplastic syndrome in cancer patients.
• Cancer patients with ATE face higher mortality risks compared to non-cancer patients.

Purpose of the Study:

• To review the epidemiology, clinical presentation, and management of cancer-associated ATE.
• To highlight the increased incidence of ATE preceding cancer diagnosis.
• To discuss prevention strategies and treatment outcomes for ATE in the context of cancer.

Main Methods:

• Systematic review of matched cohort studies, systematic reviews, and observational studies.
• Analysis of incidence, morbidity, and mortality data for cancer-associated ATE.
• Evaluation of current prevention and treatment approaches.

Main Results:

• An increased incidence of ATE, including acute coronary events and ischemic stroke, occurs in the 6 months preceding cancer diagnosis.
• Cancer patients with ATE exhibit worse in-hospital and long-term mortality.
• Efficacy of statins and antiplatelet agents for ATE prevention in cancer patients is not yet established.
• Revascularization outcomes for cancer-associated ATE are poorer than in non-cancer patients.

Conclusions:

• Cancer is a significant risk factor for ATE, necessitating proactive identification and management.
• Multidisciplinary care involving oncologists, vascular specialists, and palliative medicine is essential for optimal decision-making.
• Further research is needed to establish effective prophylactic and therapeutic strategies for cancer-associated ATE.