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Acute Coronary Syndrome Management in Cancer Patients

  • Cardio-oncology (EH Yang, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Coronary artery disease and cancer often co-exist. Patients with cancer have been excluded by most major cardiology trials and registries and their management remains largely empiric. Cancer patients experience an approximately 10-times increased mortality compared to the general population. Conservative therapy of ACS in cancer therapy results in 1-year mortality of 74%. This review article aims to describe the mechanisms of acute coronary syndromes in cancer patients, their clinical presentation, and their management.

Recent Findings

Newer studies have shed light on the mechanisms of ACS in cancer patients, which are different and related to the type of malignancy and its associated therapy. Medication-specific coronary effects (vasospasm, endothelial dysfunction, spontaneous thrombosis, accelerated atherosclerosis), radiation vasculitis, cancer cell coronary embolism, and coronary compression from thoracic malignancies are unique ACS mechanisms in cancer patients.

Summary

Close collaboration between oncologists and cardiologists for thoughtful patient selection and decision making strategies is necessary to provide optimal medical care.

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Author information

Authors and Affiliations

  1. University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care System, 4301 W Markham St, Little Rock, AR, 72205, USA

    Malek Al-Hawwas

  2. Wayne State University, 42 W Warren Ave, Detroit, MI, 48202, USA

    Despina Tsitlakidou

  3. Academy of the Lakes, 2331 Collier Pkwy, Land O, Lakes, FL, 34639, USA

    Neha Gupta

  4. MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Cezar Iliescu

  5. Arkansas Heart Hospital, 1701 South Shackleford Rd., Little Rock, AR, 72211, USA

    Mehmet Cilingiroglu

  6. Florida Hospital, Pepin Heart Institute, 3100 E Fletcher Ave, Tampa, FL, 33613, USA

    Konstantinos Marmagkiolis

Authors
  1. Malek Al-Hawwas
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  2. Despina Tsitlakidou
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  3. Neha Gupta
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  4. Cezar Iliescu
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  5. Mehmet Cilingiroglu
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  6. Konstantinos Marmagkiolis
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Corresponding author

Correspondence to Malek Al-Hawwas.

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Conflict of Interest

Malek Al-Hawwas, Despina Tsitlakidou, Neha Gupta, Cezar Iliescu, Mehmet Cilingiroglu, and Konstantinos Marmagkiolis declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cardio-oncology

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Al-Hawwas, M., Tsitlakidou, D., Gupta, N. et al. Acute Coronary Syndrome Management in Cancer Patients. Curr Oncol Rep 20, 78 (2018). https://doi.org/10.1007/s11912-018-0724-8

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  • DOI: https://doi.org/10.1007/s11912-018-0724-8

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