Published in:
Open Access 01-12-2020 | Acute Coronary Syndrome | Commentary
Ischaemic heart disease and Cancer: competing malignant conditions
Published in: BMC Cardiovascular Disorders | Issue 1/2020
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Background
The growing population of cancer survivors and their high frequency of cardiovascular disease have resulted in a dramatic increase in cancer patients requiring cardiovascular intervention. However, there is a lack of evidence to guide optimal management in this complex population who have historically been excluded from cardiovascular trials.
Discussion
We review the recently published meta-analysis by Roule et al. The findings of this analysis demonstrate that patients with cancer presenting with acute coronary syndrome (ACS) have increased rates of in-hospital cardiovascular mortality, bleeding and one-year cardiovascular mortality. All-cause mortality measured in-hospital and at one-year were also significantly greater in cancer patients as was all-cause mortality in cancer patients that undergo percutaneous coronary intervention (PCI). In contrast to the short-term outcomes, rates of long-term cardiovascular mortality did not differ significantly between groups.
Summary
Patient-specific assessment of risk, accounting for disease characteristics and treatment, and close communication with oncology providers is vital in defining optimal treatment strategies in this population.