Cardio-oncology: a cardiologist's view on the problem of endovascular treatment of patients with coronary artery disease and severe aortic valve stenosis combined with cancer: a literature review

Cardio-oncology is a new medical direction which is responsible for the prevention of development, diagnosis and treatment of cardiovascular disease (CVD) in patients with cancer. The prevalence of cardiac pathology in cancer patients turned out to be unexpectedly high, while only half of the patients with pathology of two systems are referred to a cardiologist for consultation and receive optimal therapy. The coincidence of risk fa­ctors for CVD and cancer suggests that these diseases have common underlying biological and molecular mechanisms. Antitumor therapy and radiation therapy can also contribute to the onset and progression of CVD. Diagnosis of coronary artery disease (CAD) in patients with cancer is difficult, since this group of patients often lacks typical angina pain, and the most common complaint is dyspnea. Endovascular surgery for CAD and severe aortic valve stenosis can be an effective and safe method for treating patients with concomitant cancer. However, given the heterogeneity of cancer diseases and the fact that these patients were not included in most randomized trials studying the CVD treatment, further research is required in this area. Aim. To analyze the literature on the etiopathogenesis of CVD in cancer patients, as well as the clinical features of CAD and aortic valve stenosis in cancer patients and the potential of innovative endovascular technologies. Conclusion. For management and treatment of such severe comorbid patients, the participation of a multidisciplinary team and a personalized approach to each patient are necessary.