DIFFICULTIES IN MANAGING PATIENTS WITH ACUTE CORONARY SYNDROME AND CANCER
Abstract
Patients with acute coronary syndrome in combination with cancer have a high risk of adverse outcomes both in hospital andand long-term period. However, most information about the
management of these patients comes from observational studies, since this group of patients is often an exclusion criterion for many randomized controlled trials. An analysis of publications devoted to diagnostic and treatment tactics for managing patients with acute coronary syndrome and cancer was carried out using databases Elibrary.ru, Scopus, PubMed and Google Scholar. The literature review included 39 publications reflecting the main pathogenetic mechanisms of the development of acute coronary syndrome in cancer patients, as well as the difficulties of diagnosis and treatment that clinicians may encounter when managing these patients. The identified articles included expert consensus, clinical guidelines, clinical trial data, and previously published literature reviews. Particular attention is paid to the need to take into account the risk of ischemic and hemorrhagic events, as well as the advisability of making clinical decisions by a multidisciplinary team.
References
Васюк Ю.А., Гендлин Г.Е., Емелина Е.И. и др. Согласованное мнение российских экспертов по профилактике, диагностике и лечению сердечно-сосудистой токсичности противоопухолевой терапии. Российский кардиологический журнал. 2021; 26(9): 152–233. DOI:10.15829/15604071-2021-4703.
Лубоятникова Е.С., Дупляков Д.В. Острый коронарный синдром у пациентов со злокачественными новообразованиями. Российский кардиологический журнал. 2017; 3(143): 140–4. DOI: 10.15829/1560-4071-2017-3-140-144.
Нарушение липидного обмена. Клинические рекомендации. Российское кардиологическое общество. URL: http://disuria.ru/_ld/12/1257_kr23E78MZ.pdf (дата обращения: 19.10.2023).
Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы. Клинические рекомендации. Российское кардиологическое общество. Ассоциация сердечно-сосудистых хирургов России. Российский кардиологический журнал. 2020; 25(11): 251–310. DOI: 10.15829/1560-4071-2020-4103.
Плохова Е.В., Дундуа Д.П. Основные принципы профилактики и лечения кардиотоксичности на фоне химиотерапии у онкологических пациентов. Клиническая практика. 2019; 10(1): 31–41. DOI: 10.17816/clinpract10130-40.
Суджаева О.А. Основные принципы ведения онкологических пациентов с Хроническими коронарными синдромами. Кардиология в Беларуси. 2023; 15(1): 112–28. DOI: 10.34883/PI.2023.15.1.009.
Agnelli G., Becattini C., Meyer G. et al. Apixaban for the treatment of venous thromboembolism associated with cancer. N Engl J Med. 2020; 382: 1599–1607. DOI: 10.1056/NEJMoa1915103.
Alyesil C., Yilmaz S., Ozturan I.U. et al. Reliability of chest pain risk scores in cancer patients with suspected acute coronary syndrome. Clin Exp Emerg Med. 2020; 7(4): 275–80. DOI: 10.15441/ceem.19.088.
Balanescu D., Donisan T., Deswal A. et al. Acute myocardial infarction in a high-risk cancer population: Outcomes following conservative versus invasive management. Int J Cardiol. 2020; 313: 1–8. DOI: 10.1016/j.ijcard.2020.04.0.
Bharadwaj A., Potts J., Mohamed M.O. et al. Acute myocardial infarction treatments and outcomes in 6.5 million patients with a current or historical diagnosis of cancer in the USA. Eur Heart J. 2020; 41(23): 2183–93. DOI: 10.1093/eurheartj/ehz851.
Byrne R.A., Rossello X., Coughlan J.J. et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38): 3720–3826. DOI: 10.1093/eurheartj/ehad19.
Collet J.P., Thiele H., Barbato E. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021; 42(14): 1289–1367. DOI: 10.1093/eurheartj/ehaa575.
Costa I.B.S.D.S., Andrade F.T.A., Carter D. et al. Challenges and Management of Acute Coronary Syndrome in Cancer Patients. Front Cardiovasc Med. 2021; 8: 590016. DOI: 10.3389/fcvm.202.
Doolub G., Mamas M.A. Percutaneous Coronary Angioplasty in Patients with Cancer: Clinical Challenges and Management Strategies. J Pers Med. 2022; 12(9): 1372. DOI: 10.3390/jpm12091372.
Gargiulo G., Costa F., Ariotti S. et al. Impact of proton pump inhibitors on clinical outcomes in patients treated with a 6- or 24-month dual-antiplatelet therapy duration: insights from the PROlonging Dual-antiplatelet treatment after Grading stent-induced Intimal hyperplasia studY trial. Am Heart J. 2016; 174: 95–102. DOI: 10.1016/j.ahj.2016.01.015.
Gevaert S.A., Halvorsen S., Sinnaeve P.R. et al. Evaluation and management of cancer patients presenting with acute cardiovascular disease: a Consensus Document of the Acute CardioVascular Care (ACVC) association and the ESC council of Cardio-Oncology. Part 1: acute coronary syndromes and acute pericardial diseases, European Heart Journal. Acute Cardiovascular Care. 2021; 10(8): 947–59. DOI: 10.1093/ehjacc/zuab056.
Guddati A.K., Joy P.S., Kumar G. Analysis of outcomes of percutaneous coronary intervention in metastatic cancer patients with acute coronary syndrome over a 10-year period. J Cancer Res Clin Oncol. 2016; 142(2): 471–9. DOI: 10.1007/s00432-015-2056-5.
Guha A., Dey A.K., Kalra A. et al. Coronary artery bypass grafting in cancer patients: prevalence and outcomes in the United States. Mayo Clin Proc. 2020; 95: 1865–76. DOI: 10.1016/j.mayocp.2020.05.044.
Gulacsi-Bardos P., Szokol M., Lodi M.D. et al. Ischaemic heart disease in cancer patients. Questions and problems. Orv Hetil. 2017; 158(43): 1691–7. DOI: 10.1556/650.2017.30897.
Iannaccone M., D’Ascenzo F., Vadala P. et al. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy. European Heart Journal. Acute Cardiovascular Care. 2018; 7(7): 631–8. DOI: 10.1177/2048872617706501.
Lee Y.K., Lim H.S., Choi Y.I. et al. Impact of Concomitant Use of Proton Pump Inhibitors and Clopidogrel on Recurrent Stroke and Myocardial Infarction. Pharmaceuticals (Basel). 2023; 16(9): 1213. DOI: 10.3390/ph16091213.
Lofling L.L., Stoer N.C., Andreassen B.K. et al. Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: a Norwegian population-based cohort study. Breast Cancer Res. 2023; 25(1): 101. DOI: 10.1186/s13058-023-01697-2.
Luca F., Parrini I., Abrignani M.G. et al. Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It. J Clin Med. 2022; 11(7): 1792. DOI: 10.3390/jcm11071792.
Lyon A.R., Lopez-Fernandez T., Couch L.S. et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022; 43(41): 4229–4361. DOI: 10.1093/eurheartj/ehac244.
Milazzo V., Cosentino N., Campodonico J. et al. Characteristics, management, and outcomes of acute coronary syndrome patients with cancer. J Clin Med. 2020; 9(11): 36–42. DOI: 10.3390/jcm9113642.
Mohamed M.O., Van Spall H.G.C., Kontopantelis E. et al. Effect of primary percutaneous coronary intervention on in-hospital outcomes among active cancer patients presenting with ST-elevation myocardial infarction: a propensity score matching analysis. Eur Heart J Acute Cardiovasc Care. 2021; 10: 829–39. DOI: 10.1093/ehjacc/zuaa032.
Nasser N.J., Fox J. Agbarya A. Potential mechanisms of cancer-related hypercoagulability. Cancers (Basel). 2020; 12(3): 566–76. DOI: 10.3390/cancers12030566.
Neumann F.J., Sousa-Uva M., Ahlsson A. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Euro Intervention. 2019; 14(14): 1435–534. DOI: 10.4244/EIJY19M01_01.
Oren O., Herrmann J. Arterial events in cancer patients — the case of acute coronary thrombosis. J Thorac Dis. 2018; 10: S4367–85. DOI: 10.21037/jtd.2018.12.79.
Radmilovic J., Di Vilio A., D’Andrea A. et al. The Pharmacological Approach to Oncologic Patients with Acute Coronary Syndrome. J Clin Med. 2020; 9(12): 3926. DOI: 10.3390/jcm9123926.
Ricco N., Kron S.J. Statins in Cancer Prevention and Therapy. Cancers (Basel). 2023; 15(15): 3948. DOI: 10.3390/cancers15153948.
Shoji K., Zen K., Ookura T. et al. Early stent thrombosis confirmed in a cancer patient receiving regorafenib, despite triple antithrombotic therapy: a case report. BMC Cardiovasc Disord. 2021; 21(1): 60. DOI: 10.1186/s12872-021-01888-9.
Todorova V.K., Hsu P.C., Wei J.Y. et al. Biomarkers of inflammation, hypercoagulability and endothelial injury predict early asymptomatic doxorubicin-induced cardiotoxicity in breast cancer patients. Am J Cancer Res. 2020; 10(9): 2933–45.
Ueki Y., Vogeli B., Karagiannis A. et al. Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention. JACC CardioOncol. 2019; 1(2): 145–55. DOI: 10.1016/j.jaccao.2019.11.001.
Urban P., Mehran R., Colleran R. et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk. Eur Heart J. 2019; 40: 2632–53. DOI: 10.1093/eurheartj/ehz372.
Valgimigli M., Bueno H., Byrne R.A. et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018; 39: 213–60. DOI: 10.1093/eurheartj/ehx419.
Yetis S.B., Oto M.A. Acute coronary syndrome in cancer patients. Am J Cardiovasc Drugs. 2018; 18: 361–72. DOI: 10.1007/s40256-018-0286-z.
Yusuf S.W., Daraban N., Abbasi N. et al. Treatment and outcomes of acute coronary syndrome in the cancer population. Clin Cardiol. 2012; 35(7): 443–50. DOI: 10.1002/clc.22007.
Zhou J., Zhan C., Zhou J. et al. Case report: Persistent ST-segment elevation due to cardiac metastasis from lung cancer. Front Cardiovasc. 2023; 10: 1001527. DOI: 10.3389/fcvm.2023.1001527.
