Key result
Acute coronary syndrome develops in 1.9-4.2% of patients following an oncologic diagnosis, predominantly presenting as non-ST elevation ACS (>85%).
Management of ACS in oncology patients requires a multidisciplinary approach due to specific risks like thrombocytopenia, cardiotoxicity, and hemostasis shifts, which are currently outside standard guidelines.
Acute coronary syndrome (ACS) during the time after diagnosis of oncologic disease, develops in 1,9-4,2% patients, and not seldom in intact coronary arteries. In ACS morbidity structure there is mostly non-ST elevation ACS (>85%). Specific factors for its development are thrombocytopenia, incl. the one caused by chemotherapy, and radiotherapy. Patients with active oncologic process have higher risk of death during ACS treatment than patients already “cured”. Tactics of ACS in oncology remains outside current guidelines; as such patients were not included in randomized trials. Still, some studies showed efficacy of acetylsalicylic acid, double antiplatelet therapy, percutaneous interventions. However, hemostasis system shifts, cardiotoxicity of chemotherapeutic agents, radiotherapy risks make the multidisciplinary approach necessary in management of ACS in this sort of patients.
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Luboyatnikova et al. (2017) conducted a review in Acute coronary syndrome in malignancy patients. Acute coronary syndrome develops in 1.9-4.2% of patients following an oncologic diagnosis, predominantly presenting as non-ST elevation ACS (>85%).
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