Top

Published in:

01-02-2018 | Coronary Heart Disease (S. Virani and S. Naderi, Section Editors)

Chemotherapeutic Agents and the Risk of Ischemia and Arterial Thrombosis

Authors: Saamir A. Hassan, Nicolas Palaskas, Peter Kim, Cezar Iliescu, Juan Lopez-Mattei, Elie Mouhayar, Rohit Mougdil, Kara Thompson, Jose Banchs, Syed Wamique Yusuf

Published in: Current Atherosclerosis Reports | Issue 2/2018

Abstract

Purpose of Review

Numerous chemotherapeutic agents have been associated with the development of ischemia and arterial thrombosis. As newer therapies have been developed to treat cancer, some of these chemotherapy drugs have been implicated in the development of vascular disease. In this review, we will summarize the most common chemotherapeutic drug classes that may play a role in the development of ischemic heart disease.

Recent Findings

Angiogenesis inhibitors, alkylating agents, antimetabolites, antimicrotubules, and proteasome inhibitors have a number of cardiovascular toxicities. The possible mechanisms of action of these drugs leading to ischemic complications are varied but include endothelial dysfunction, platelet aggregation, reduced levels of nitrous oxide (NO), and elevated levels of reactive oxygen species (ROS), and vasospasm. While some drugs act through multiple pathways that result in the development of ischemic heart disease, others such as the antimetabolites and antimicrotubules appear to primarily cause vasospasm. Furthermore, while aromatase inhibitors increase the risk of heart disease in comparison to tamoxifen in large studies, this finding likely occurs because of a protective role of tamoxifen on cardiovascular risk factors rather than a direct effect of aromatase inhibitors.

Summary

Angiogenesis inhibitors, alkylating agents, antimetabolites, antimicrotubules, and proteasome inhibitors can lead to ischemic complications in patients with cancer. Many of these drugs have proven to be effective in improving cancer prognosis, but their possible cardiovascular effects have to be carefully monitored and treated. Treatment of ischemic complications in the setting of cancer therapy should focus on the optimal medical management of known cardiovascular risk factors and follow an evidence-based approach.

Fuster V, Voute J. MDGs: chronic diseases are not on the agenda. Lancet. 2005;366(9496):1512–4. https://doi.org/10.1016/S0140-6736(05)67610-6.CrossRefPubMed

American Cancer Society. Cancer Facts & Figures 2015 Atlanta: American Cancer Society; 2015.

Cancer: Fact Sheet (Internet). World Health Organization 2017. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/.

Yusuf SW, Razeghi P, Yeh ET. The diagnosis and management of cardiovascular disease in cancer patients. Curr Probl Cardiol. 2008;33(4):163–96. https://doi.org/10.1016/j.cpcardiol.2008.01.002.CrossRefPubMed

Basavaraju SR, Jones TD. Atherosclerotic risks from chemicals: part I. Toxicological observations and mechanisms of atherosclerosis. Arch Environ Contam Toxicol. 1998;35(1):152–64. https://doi.org/10.1007/s002449900363.CrossRefPubMed

Ross JS, Stagliano NE, Donovan MJ, Breitbart RE, Ginsburg GS. Atherosclerosis and cancer: common molecular pathways of disease development and progression. Ann N Y Acad Sci. 2001;947:271–92. discussion 92-3CrossRefPubMed

Lestuzzi C, Viel E, Picano E, Meneguzzo N. Coronary vasospasm as a cause of effort-related myocardial ischemia during low-dose chronic continuous infusion of 5-fluorouracil. Am J Med. 2001;111(4):316–8. https://doi.org/10.1016/S0002-9343(01)00808-7.CrossRefPubMed

Bathina JD, Yusuf SW. 5-Fluorouracil-induced coronary vasospasm. J Cardiovasc Med. 2010;11(4):281–4. https://doi.org/10.2459/JCM.0b013e32832e934b.CrossRef

Schwarzer S, Eber B, Greinix H, Lind P. Non-Q-wave myocardial infarction associated with bleomycin and etoposide chemotherapy. Eur Heart J. 1991;12(6):748–50.PubMed

10.

Stefenelli T, Kuzmits R, Ulrich W, Glogar D. Acute vascular toxicity after combination chemotherapy with cisplatin, vinblastine, and bleomycin for testicular cancer. Eur Heart J. 1988;9(5):552–6. https://doi.org/10.1093/oxfordjournals.eurheartj.a062542.CrossRefPubMed

11.

Stefenelli T, Zielinski CC, Mayr H, Scoheithauer W. Prinzmetal’s angina during cyclophosphamide therapy. Eur Heart J. 1988;9(10):1155–7. https://doi.org/10.1093/oxfordjournals.eurheartj.a062414.CrossRefPubMed

12.

Cheriparambil KM, Vasireddy H, Kuruvilla A, Gambarin B, Makan M, Saul BI. Acute reversible cardiomyopathy and thromboembolism after cisplatin and 5-fluorouracil chemotherapy—a case report. Angiology. 2000;51(10):873–8. https://doi.org/10.1177/000331970005101011.CrossRefPubMed

13.

Frickhofen N, Beck FJ, Jung B, Fuhr HG, Andrasch H, Sigmund M. Capecitabine can induce acute coronary syndrome similar to 5-fluorouracil. Ann Oncol: Off J Eur Soc Med Oncol. 2002;13(5):797–801.CrossRef

14.

Rodeghiero F, Elice F. Thalidomide and thrombosis. Pathophysiol Haemost Thromb. 2003;33(Suppl 1):15–8. https://doi.org/10.1159/000073282.CrossRefPubMed

15.

Palumbo A, Palladino C. Venous and arterial thrombotic risks with thalidomide: evidence and practical guidance. Ther Adv Drug Saf. 2012;3(5):255–66. https://doi.org/10.1177/2042098612452291.CrossRefPubMedPubMedCentral

16.

Robinson ES, Khankin EV, Karumanchi SA, Humphreys BD. Hypertension induced by vascular endothelial growth factor signaling pathway inhibition: mechanisms and potential use as a biomarker. Semin Nephrol. 2010;30(6):591–601. https://doi.org/10.1016/j.semnephrol.2010.09.007.CrossRefPubMedPubMedCentral

17.

• Abdel-Qadir H, Ethier JL, Lee DS, Thavendiranathan P, Amir E. Cardiovascular toxicity of angiogenesis inhibitors in treatment of malignancy: a systematic review and meta-analysis. Cancer Treatment Rev. 2017;53:120–7. A very good review of cardiovascular toxicity associated with angiogensis inhbitors. CrossRef

18.

• Choueiri TK, Schutz FA, Je Y, Rosenberg JE, Bellmunt J. Risk of arterial thromboembolic events with sunitinib and sorafenib: a systematic review and meta-analysis of clinical trials. J Clin Oncol: Off J Am Soc Clin Oncol. 2010;28(13):2280–5. A meta-analysis of arterial thrombosis due to tyrosine kinase-based cancer therapies. CrossRef

19.

Qi WX, Shen Z, Tang LN, Yao Y. Risk of arterial thromboembolic events with vascular endothelial growth factor receptor tyrosine kinase inhibitors: an up-to-date meta-analysis. Crit Rev Oncol Hematol. 2014;92(2):71–82. https://doi.org/10.1016/j.critrevonc.2014.04.004.CrossRefPubMed

20.

Schutz FA, Je Y, Richards CJ, Choueiri TK. Meta-analysis of randomized controlled trials for the incidence and risk of treatment-related mortality in patients with cancer treated with vascular endothelial growth factor tyrosine kinase inhibitors. J Clin Oncol: Off J Am Soc Clin Oncol. 2012;30(8):871–7. https://doi.org/10.1200/JCO.2011.37.1195.CrossRef

21.

Je Y, Schutz FA, Choueiri TK. Risk of bleeding with vascular endothelial growth factor receptor tyrosine-kinase inhibitors sunitinib and sorafenib: a systematic review and meta-analysis of clinical trials. Lancet Oncol. 2009;10(10):967–74. https://doi.org/10.1016/S1470-2045(09)70222-0.CrossRefPubMed

22.

Fu D, Calvo JA, Samson LD. Balancing repair and tolerance of DNA damage caused by alkylating agents. Nat Rev Cancer. 2012;12(2):104–20. https://doi.org/10.1038/nrc3185.CrossRefPubMedPubMedCentral

23.

Gottdiener JS, Appelbaum FR, Ferrans VJ, Deisseroth A, Ziegler J. Cardiotoxicity associated with high-dose cyclophosphamide therapy. Arch Intern Med. 1981;141(6):758–63. https://doi.org/10.1001/archinte.1981.00340060066015.CrossRefPubMed

24.

Soultati A, Mountzios G, Avgerinou C, Papaxoinis G, Pectasides D, Dimopoulos MA, et al. Endothelial vascular toxicity from chemotherapeutic agents: preclinical evidence and clinical implications. Cancer Treat Rev. 2012;38(5):473–83. https://doi.org/10.1016/j.ctrv.2011.09.002.CrossRefPubMed

25.

Appelbaum F, Strauchen JA, Graw RG Jr, Savage DD, Kent KM, Ferrans VJ, et al. Acute lethal carditis caused by high-dose combination chemotherapy. A unique clinical and pathological entity. Lancet. 1976;1(7950):58–62.CrossRefPubMed

26.

Nuver J, Smit AJ, Sleijfer DT, van Gessel AI, van Roon AM, van der Meer J, et al. Microalbuminuria, decreased fibrinolysis, and inflammation as early signs of atherosclerosis in long-term survivors of disseminated testicular cancer. Eur J Cancer. 2004;40(5):701–6. https://doi.org/10.1016/j.ejca.2003.12.012.CrossRefPubMed

27.

Weijl NI, Rutten MF, Zwinderman AH, Keizer HJ, Nooy MA, Rosendaal FR, et al. Thromboembolic events during chemotherapy for germ cell cancer: a cohort study and review of the literature. J Clin Oncol: Off J Am Soc Clin Oncol. 2000;18(10):2169–78. https://doi.org/10.1200/JCO.2000.18.10.2169.CrossRef

28.

Meinardi MT, Gietema JA, van Veldhuisen DJ, van der Graaf WT, de Vries EG, Sleijfer DT. Long-term chemotherapy-related cardiovascular morbidity. Cancer Treat Rev. 2000;26(6):429–47. https://doi.org/10.1053/ctrv.2000.0175.CrossRefPubMed

29.

Luke DR, Vadiei K, Lopez-Berestein G. Role of vascular congestion in cisplatin-induced acute renal failure in the rat. Nephrol Dialysis Trans : Off Publ Eur Dialysis Trans Assoc—Eur Renal Assoc. 1992;7(1):1–7.

30.

Meinardi MT, Gietema JA, van der Graaf WT, van Veldhuisen DJ, Runne MA, Sluiter WJ, et al. Cardiovascular morbidity in long-term survivors of metastatic testicular cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 2000;18(8):1725–32. https://doi.org/10.1200/JCO.2000.18.8.1725.CrossRef

31.

Fung C, Fossa SD, Milano MT, Sahasrabudhe DM, Peterson DR, Travis LB. Cardiovascular disease mortality after chemotherapy or surgery for testicular nonseminoma: a population-based study. J Clin Oncol: Off J Am Soc Clin Oncol. 2015;33(28):3105–15. https://doi.org/10.1200/JCO.2014.60.3654.CrossRef

32.

Quezado ZM, Wilson WH, Cunnion RE, Parker MM, Reda D, Bryant G, et al. High-dose ifosfamide is associated with severe, reversible cardiac dysfunction. Ann Intern Med. 1993;118(1):31–6. https://doi.org/10.7326/0003-4819-118-1-199301010-00006.CrossRefPubMed

33.

Bleeker JS, Gertz MA, Pellikka PA, Larson DR, Buadi F, Dingli D, et al. Evaluation of pretransplant factors predicting cardiac dysfunction following high-dose melphalan conditioning and autologous peripheral blood stem cell transplantation. Eur J Haematol. 2012;89(3):228–35. https://doi.org/10.1111/j.1600-0609.2012.01815.x.CrossRefPubMed

34.

Gil L, Kazmierczak M, Kroll-Balcerzak R, Komarnicki M. Bendamustine-based therapy as first-line treatment for non-Hodgkin lymphoma. Med Oncol. 2014;31(5):944. https://doi.org/10.1007/s12032-014-0944-1.CrossRefPubMedPubMedCentral

35.

Herrmann J, Yang EH, Iliescu CA, Cilingiroglu M, Charitakis K, Hakeem A, et al. Vascular toxicities of cancer therapies: the old and the new—an evolving avenue. Circulation. 2016;133(13):1272–89. https://doi.org/10.1161/CIRCULATIONAHA.115.018347.CrossRefPubMedPubMedCentral

36.

Saif MW, Shah MM, Shah AR. Fluoropyrimidine-associated cardiotoxicity: revisited. Expert Opin Drug Saf. 2009;8(2):191–202. https://doi.org/10.1517/14740330902733961.CrossRefPubMed

37.

Wacker A, Lersch C, Scherpinski U, Reindl L, Seyfarth M. High incidence of angina pectoris in patients treated with 5-fluorouracil. A planned surveillance study with 102 patients. Oncology. 2003;65(2):108–12. https://doi.org/10.1159/000072334.CrossRefPubMed

38.

Sudhoff T, Enderle MD, Pahlke M, Petz C, Teschendorf C, Graeven U, et al. 5-Fluorouracil induces arterial vasocontractions. Ann Oncol: Off J Eur Soc Med Oncol. 2004;15(4):661–4.CrossRef

39.

Tsavaris N, Kosmas C, Vadiaka M, Efremidis M, Zinelis A, Beldecos D, et al. Cardiotoxicity following different doses and schedules of 5-fluorouracil administration for malignancy—a survey of 427 patients. Med Sci Monit. 2002;8(6):Pi51–7.PubMed

40.

de Forni M, Malet-Martino MC, Jaillais P, Shubinski RE, Bachaud JM, Lemaire L, et al. Cardiotoxicity of high-dose continuous infusion fluorouracil: a prospective clinical study. J Clin Oncol: Off J Am Soc Clin Oncol. 1992;10(11):1795–801. https://doi.org/10.1200/JCO.1992.10.11.1795.CrossRef

41.

JI L, Carhart RL, Graziano SL, Gajra A. Acute coronary syndrome secondary to fluorouracil infusion. J Clin Oncol: Off J Am Soc Clin Oncol. 2006;24(18):2959–60.CrossRef

42.

Cardinale D, Colombo A, Colombo N. Acute coronary syndrome induced by oral capecitabine. Can J Cardiol. 2006;22(3):251–3. https://doi.org/10.1016/S0828-282X(06)70905-9.CrossRefPubMedPubMedCentral

43.

Labianca R, Beretta G, Clerici M, Fraschini P, Luporini G. Cardiac toxicity of 5-fluorouracil: a study on 1083 patients. Tumori. 1982;68(6):505–10.PubMed

44.

Henry D, Rudzik F, Butts A, Mathew A. Capecitabine-induced coronary vasospasm. Case Rep Oncol. 2016;9(3):629–32. https://doi.org/10.1159/000450544.CrossRefPubMedPubMedCentral

45.

Ozturk B, Tacoy G, Coskun U, Yaman E, Sahin G, Buyukberber S, et al. Gemcitabine-induced acute coronary syndrome: a case report. Med Princ Pract. 2009;18(1):76–80. https://doi.org/10.1159/000163051.CrossRefPubMed

46.

Jordan MA, Wilson L. Microtubules as a target for anticancer drugs. Nat Rev Cancer. 2004;4(4):253–65. https://doi.org/10.1038/nrc1317.CrossRefPubMed

47.

Ganguly A, Yang H, Cabral F. Paclitaxel-dependent cell lines reveal a novel drug activity. Mol Cancer Ther. 2010;9(11):2914–23. https://doi.org/10.1158/1535-7163.MCT-10-0552.CrossRefPubMedPubMedCentral

48.

McGuire WP, Rowinsky EK, Rosenshein NB, Grumbine FC, Ettinger DS, Armstrong DK, et al. Taxol: a unique antineoplastic agent with significant activity in advanced ovarian epithelial neoplasms. Ann Intern Med. 1989;111(4):273–9. https://doi.org/10.7326/0003-4819-111-4-273.CrossRefPubMed

49.

Arbuck SG, Strauss H, Rowinsky E, Christian M, Suffness M, Adams J, et al. A reassessment of cardiac toxicity associated with Taxol. J Natl Cancer Inst Monogr. 1993;15:117–30.

50.

Schrader C, Keussen C, Bewig B, von Freier A, Lins M. Symptoms and signs of an acute myocardial ischemia caused by chemotherapy with paclitaxel (Taxol) in a patient with metastatic ovarian carcinoma. Eur J Med Res. 2005;10(11):498–501.PubMed

51.

Gemici G, Cincin A, Degertekin M, Oktay A. Paclitaxel-induced ST-segment elevations. Clin Cardiol. 2009;32(6):E94–6. https://doi.org/10.1002/clc.20291.CrossRefPubMed

52.

Howarth FC, Calaghan SC, Boyett MR, White E. Effect of the microtubule polymerizing agent taxol on contraction, Ca2+ transient and L-type Ca2+ current in rat ventricular myocytes. J Physiol. 1999;516(Pt 2):409–19. https://doi.org/10.1111/j.1469-7793.1999.0409v.x.CrossRefPubMedPubMedCentral

53.

Redana S, Sharp A, Lote H, Mohammed K, Papadimitraki E, Capelan M, et al. Rates of major complications during neoadjuvant and adjuvant chemotherapy for early breast cancer: an off study population. Breast. 2016;30:13–8. https://doi.org/10.1016/j.breast.2016.07.019.CrossRefPubMed

54.

Laubach JP, Moslehi JJ, Francis SA, San Miguel JF, Sonneveld P, Orlowski RZ, et al. A retrospective analysis of 3954 patients in phase 2/3 trials of bortezomib for the treatment of multiple myeloma: towards providing a benchmark for the cardiac safety profile of proteasome inhibition in multiple myeloma. Br J Haematol. 2017;178(4):547–60. https://doi.org/10.1111/bjh.14708.CrossRefPubMed

55.

Takamatsu H, Yamashita T, Kotani T, Sawazaki A, Okumura H, Nakao S. Ischemic heart disease associated with bortezomib treatment combined with dexamethasone in a patient with multiple myeloma. Int J Hematol. 2010;91(5):903–6. https://doi.org/10.1007/s12185-010-0586-9.CrossRefPubMed

56.

Stewart AK, Rajkumar SV, Dimopoulos MA, Masszi T, Špička I, Oriol A, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2014;372(2):142–52. https://doi.org/10.1056/NEJMoa1411321.CrossRefPubMed

57.

Chen-Scarabelli C, Corsetti G, Pasini E, Dioguardi FS, Sahni G, Narula J, et al. Spasmogenic effects of the proteasome inhibitor carfilzomib on coronary resistance, vascular tone and reactivity. EBioMedicine. 2017;21:206–12. https://doi.org/10.1016/j.ebiom.2017.05.024.CrossRefPubMedPubMedCentral

58.

Hou J, Jin J, Xu Y, Wu D, Ke X, Zhou D, et al. Randomized, double-blind, placebo-controlled phase III study of ixazomib plus lenalidomide-dexamethasone in patients with relapsed/refractory multiple myeloma: China continuation study. J Hematol Oncol. 2017;10(1):137. https://doi.org/10.1186/s13045-017-0501-4.CrossRefPubMedPubMedCentral

59.

Moreau P, Masszi T, Grzasko N, Bahlis NJ, Hansson M, Pour L, et al. Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;374(17):1621–34. https://doi.org/10.1056/NEJMoa1516282.CrossRefPubMed

60.

American Cancer Society. Cancer Facts & Figures 2017. Atlanta: American Cancer Society; 2017.

61.

Burstein HJ, Lacchetti C, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, et al. Adjuvant endocrine therapy for women with hormone receptor–positive breast cancer: American Society of Clinical Oncology clinical practice guideline update on ovarian suppression. J Clin Oncol. 2016;34(14):1689–701. https://doi.org/10.1200/JCO.2015.65.9573.CrossRefPubMed

62.

Simpson ER. Sources of estrogen and their importance. J Steroid Biochem Mol Biol. 2003;86(3–5):225–30. https://doi.org/10.1016/S0960-0760(03)00360-1.CrossRefPubMed

63.

Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;89(12a):12E–7E. discussion 7E-8ECrossRefPubMed

64.

Haas MJ, Raheja P, Jaimungal S, Sheikh-Ali M, Mooradian AD. Estrogen-dependent inhibition of dextrose-induced endoplasmic reticulum stress and superoxide generation in endothelial cells. Free Radic Biol Med. 2012;52(11–12):2161–7. https://doi.org/10.1016/j.freeradbiomed.2012.04.009.CrossRefPubMed

65.

Haque R, Shi J, Schottinger JE, Chung J, Avila C, Amundsen B, et al. Cardiovascular disease after aromatase inhibitor use. JAMA Oncol. 2016;2(12):1590–7. https://doi.org/10.1001/jamaoncol.2016.0429.CrossRefPubMed

66.

Khosrow-Khavar F, Filion KB, Al-Qurashi S, Torabi N, Bouganim N, Suissa S, et al. Cardiotoxicity of aromatase inhibitors and tamoxifen in postmenopausal women with breast cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Oncol: Off J Eur Soc Med Oncol. 2017;28(3):487–96.

67.

Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al. ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Col Cardiol. 2012;60(24):e44–e164.CrossRef

68.

Yusuf SW, Daraban N, Abbasi N, Lei X, Durand JB, Daher IN. Treatment and outcomes of acute coronary syndrome in the cancer population. Clin Cardiol. 2012;35(7):443–50. https://doi.org/10.1002/clc.22007.CrossRefPubMed

69.

Pereg D, Lishner M. Bevacizumab treatment for cancer patients with cardiovascular disease: a double edged sword? Eur Heart J. 2008;29(19):2325–6. https://doi.org/10.1093/eurheartj/ehn384.CrossRefPubMed

70.

Velders MA, Boden H, Hofma SH, Osanto S, van der Hoeven BL, Heestermans AA, et al. Outcome after ST elevation myocardial infarction in patients with cancer treated with primary percutaneous coronary intervention. Am J Cardiol. 2013;112(12):1867–72. https://doi.org/10.1016/j.amjcard.2013.08.019.CrossRefPubMed

71.

Sarkiss MG, Yusuf SW, Warneke CL, Botz G, Lakkis N, Hirch-Ginsburg C, et al. Impact of aspirin therapy in cancer patients with thrombocytopenia and acute coronary syndromes. Cancer. 2007;109(3):621–7. https://doi.org/10.1002/cncr.22434.CrossRefPubMed

72.

Yusuf SW, Iliescu C, Bathina JD, Daher IN, Durand JB. Antiplatelet therapy and percutaneous coronary intervention in patients with acute coronary syndrome and thrombocytopenia. Tex Heart Inst J. 2010;37(3):336–40.PubMedPubMedCentral

73.

• Iliescu C, Grines CL, Herrmann J, Yang EH, Cilingiroglu M, Charitakis K, et al. SCAI expert consensus statement: evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (Endorsed by the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencionista). Catheterization Cardiovas Interv: Off J Soc Cardiac Angiogr Interv. 2016;87(5):895–9. Expert consesus statement of how to manage and treat cancer patients who need invasive cardiac procedures. CrossRef

74.

Chandra S, Lenihan DJ, Wei W, Yusuf SW, Tong AT. Myocardial perfusion imaging and cardiovascular outcomes in a cancer population. Tex Heart Inst J. 2009;36(3):205–13.PubMedPubMedCentral

Title: Chemotherapeutic Agents and the Risk of Ischemia and Arterial Thrombosis
Authors: Saamir A. Hassan
Nicolas Palaskas
Peter Kim
Cezar Iliescu
Juan Lopez-Mattei
Elie Mouhayar
Rohit Mougdil
Kara Thompson
Jose Banchs
Syed Wamique Yusuf
Publication date: 01-02-2018
Publisher: Springer US
Published in: Current Atherosclerosis Reports / Issue 2/2018
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-018-0702-5

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 2/2018

Microvascular Coronary Dysfunction—an Overview

Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Statin: a Clinical Update

Nutrition and Cardiovascular Disease—an Update

Diagnostic Error in Stroke—Reasons and Proposed Solutions

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage