Cancer and arterial thrombosis: therapeutic options

Area of Science:

• Cardiology
• Oncology
• Hematology

Background:

• Cancer significantly elevates the risk of arterial thromboembolism (ATE), encompassing acute coronary syndrome, ischemic strokes, and peripheral arterial disease.
• The precise burden of cancer-associated ATE is unclear, but risks are heightened post-diagnosis, varying by cancer subtype, notably lung cancer.

Purpose of the Study:

• To review the complex relationship between cancer and arterial thromboembolism (ATE).
• To discuss the pathophysiology, diagnostic challenges, and therapeutic options for ATE in cancer patients.
• To highlight recent findings presented at the 2023 International Society on Thrombosis and Haemostasis Congress.

Main Methods:

• State-of-the-art review of existing literature and presented data.
• Analysis of pathophysiology involving hypercoagulopathy, cancer therapy, and patient risk factors.
• Consideration of specific etiologies like coronary vasospasm and non-bacterial-thrombotic endocarditis.

Main Results:

• Cancer-associated ATE exhibits unique mechanistic differences requiring tailored management.
• Standard ATE therapies are generally applicable but may need nuanced adjustments.
• Atrial fibrillation in cancer patients increases ATE risk, demanding careful anticoagulation assessment.

Conclusions:

• Cancer patients require specialized approaches for managing arterial thromboembolism.
• Awareness of ATE as a potential presenting sign of malignancy is crucial.
• Ongoing research and congress updates inform evolving therapeutic strategies.