Clinical Research Progress in the Treatment and Prognosis of Comorbid Coronary Heart Disease and Lung Cancer

Driven by global population aging and increasingly unhealthy lifestyles, the number of patients with comorbid coronary heart disease (CHD) and lung cancer is increasing, as these two diseases share common risk factors, such as smoking. There is a core contradiction in the clinical management of these diseases: radical treatment for lung cancer may increase the cardiac burden, whereas the long-term antithrombotic therapy required for CHD conflicts with the risk of bleeding during lung cancer surgery. This review summarizes recent advances in the treatment and prognosis of these comorbid diseases based on literature from the past decade. Individualized treatment is necessary: for patients with early-stage lung cancer, limited coronary artery disease, and good cardiac function, synchronous surgery may be considered; conversely, for patients with advanced lung cancer, complex coronary artery disease, or cardiac dysfunction, staged surgery is more secure, and minimally invasive techniques can help reduce trauma and accelerate recovery. Non-surgical treatments require adjustment of the radiation dose and the use of prophylactic antithrombotic therapy to balance efficacy and cardiac protection. Prognostic evaluations have shown that a low inflammatory index, extensive coronary calcification, a high SYNTAX score, and comorbid diabetes mellitus are independent risk factors for poor outcomes in lung cancer patients with CHD.