Percutaneous coronary interventions are likely the best treatment option for cancer patients with acceptable prognosis and acute coronary syndrome, despite their higher risks of complications and mortality.
Does percutaneous coronary intervention improve survival compared to a conservative approach in cancer patients with acute coronary syndrome?
Well-planned PCI is likely the best treatment option for cancer patients with ACS and an acceptable prognosis, as conservative management does not improve survival.
Effect estimate: null (95% CI null)
p-value: p=null
Cardiac disease and cancer are two of the leading causes of morbidity and mortality worldwide. The development of screening, diagnosis and treatment of both diseases and also primary and secondary prevention has resulted in an increase of cancer survivors with concomitant cardiovascular diseases. Cancer patients are on increased risk of CAD and ACS. Chemo and radiation therapy induced coronary artery injury and the increased risk of thrombosis result in higher risk of cardiovascular morbidity and mortality rate. Conservative approach in treatment of patients with ACS and any type of malignancies do not improve survival rates. In the majority of cancer patients with acceptable prognosis or cancer survivors, well planned and performed PCI is probably the best option. Physicians and medical stuff must be aware of the potential complications of cancer therapies. The management of cancer patients with acute and chronic coronary artery diseases should be individualized and discussed within the acute cardiooncology team. In terms of limited evidences, future studies are needed for investigation of well-balanced treatment strategies and improvement in survival outcome.
Salinger et al. (2021) conducted a review in malignancy. percutaneous coronary intervention (PCI) vs. conservative approach was evaluated on hospital mortality and procedural complications in cancer patients undergoing PCI (null, 95% CI null, p=null). Percutaneous coronary interventions are likely the best treatment option for cancer patients with acceptable prognosis and acute coronary syndrome, despite their higher risks of complications and mortality.