Why the study?
Managing acute coronary syndrome in cancer patients is challenging due to underused percutaneous revascularization, complex thrombotic and bleeding risks, and thrombocytopenia, warranting tailored pharmacological strategies.
What is the optimal pharmacological management of acute coronary syndrome in patients with concomitant cancer?
What is the optimal pharmacological management of acute coronary syndrome in patients with concomitant cancer?
This review emphasizes the need for individualized antiplatelet and anticoagulant therapy in cancer patients with ACS to balance thrombotic and bleeding risks.
Among acute coronary syndrome (ACS) patients, 15% have concomitant cancer, especially in the first 6 months after their diagnosis, as well as in advanced metastatic stages. Lung, gastric, and pancreatic cancers are the most frequent malignancies associated with ACS. Chemotherapy and radiotherapy exert prothrombotic, vasospastic, and proinflammatory actions. The management of cancer patients with ACS is quite challenging: percutaneous revascularization is often underused, and antiplatelet and anticoagulant pharmacological therapy should be individually tailored to the thrombotic risk and to the bleeding complications. Sometimes oncological patients also show different degrees of thrombocytopenia, which further complicates the pharmacological strategies. The aim of this review is to summarize the current evidence regarding the treatment of ACS in cancer patients and to suggest the optimal management and therapy to reduce the risk of adverse coronary events after ACS in this high-risk population.
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Radmilovic et al. (2020) studied this question.
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