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Current Treatment Options in Cardiovascular Medicine
Published in: Current Treatment Options in Cardiovascular Medicine 5/2018

01-05-2018 | Cardio-oncology (M Fradley, Section Editor)

Arterial Thrombosis in Patients with Cancer

Authors: Mirela Tuzovic, MD, Joerg Herrmann, MD, Cezar Iliescu, MD, Kostas Marmagkiolis, MD, Boback Ziaeian, MD, PhD, Eric H. Yang, MD

Published in: Current Treatment Options in Cardiovascular Medicine | Issue 5/2018

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Abstract

Purpose of review

Cancer is a common cause of morbidity and mortality in the USA. While the association between venous thrombosis and malignancy is well established, arterial thrombosis has more recently been recognized as a serious complication of cancer and certain chemotherapeutic agents. This review aims to summarize the most recent literature regarding the incidence and risk factors for cancer-related arterial thrombosis, understand the pathophysiologic mechanisms of thrombosis, and highlight the specific diagnostic and treatment considerations relevant to cancer patients.

Recent findings

Based on a recent study looking at the Surveillance, Epidemiology, and End Results (SEER) database, the incidence of arterial thromboembolic events (ATEs) in patients with cancer at 6 months is 4.7%; the presence of an ATE is predictive of worse outcomes. Certain drugs such as platinum-based agents, vascular endothelial growth factor inhibitors, tyrosine kinase inhibitors, and taxanes have been associated with high rates of ATEs. Increased platelet reactivity appears crucial to development of arterial thrombosis in cancer patients.

Summary

Cancer patients have an increased risk of arterial thrombosis that is likely due to both a cancer-associated procoagulant state as well as the adverse effects of certain chemotherapeutic agents. Treatment of arterial thromboembolism in cancer patients typically requires a multidisciplinary approach in part due to high rates of thrombocytopenia and stent thrombosis in the setting of percutaneous interventions. More studies are needed to investigate optimal prophylaxis, surveillance strategies, and treatments of cancer-related arterial thromboembolic disease.
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Metadata
Title
Arterial Thrombosis in Patients with Cancer
Authors
Mirela Tuzovic, MD
Joerg Herrmann, MD
Cezar Iliescu, MD
Kostas Marmagkiolis, MD
Boback Ziaeian, MD, PhD
Eric H. Yang, MD
Publication date
01-05-2018
Publisher
Springer US
Published in
Current Treatment Options in Cardiovascular Medicine / Issue 5/2018
Print ISSN: 1092-8464
Electronic ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-018-0635-x

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