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Atherosclerotic Cardiovascular Disease and Cancer.
Anaïs Amend1,2, Hauke Horstmann1,2, Kory J Lavine3,4
1Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
Immunological Reviews
|July 12, 2026
Summary
Atherosclerotic cardiovascular disease and cancer are linked by shared immune pathways, not just risk factors. Understanding these bidirectional immune interactions is key for managing patients with both conditions.
Area of Science:
- Immunology
- Cardiology
- Oncology
Background:
- Atherosclerotic cardiovascular disease (ASCVD) and cancer share common risk factors and immune mechanisms.
- Chronic inflammation, driven by factors like obesity and aging, promotes both pathologies.
- Clonal hematopoiesis of indeterminate potential (CHIP) contributes to this inflammatory milieu.
Purpose of the Study:
- To review the interconnectedness of ASCVD and cancer through shared immune mechanisms.
- To explore the bidirectional axes linking cardiovascular injury and cancer progression.
- To highlight the role of immune pathways in managing patients with both diseases.
Main Methods:
- Review of current mechanistic and clinical evidence.
- Analysis of immune checkpoint pathways (PD-1, CTLA-4) in atherosclerotic plaques.
- Examination of inflammatory cytokines (IL-1β, IL-6) linking atherogenesis and cancer.
Main Results:
- Cancer therapies can induce cardiovascular injury (cardio-oncology axis).
- Cardiovascular injury can promote cancer initiation and progression (reverse axis).
- Immune pathways and cytokines create a bridge between ASCVD and cancer.
Conclusions:
- ASCVD and cancer are fundamentally immune-driven diseases with bidirectional interactions.
- Immune-based stratification and inflammation modulation can improve patient management.
- Targeting shared immune mechanisms offers novel therapeutic strategies.
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