The incidence of cancer and acute coronary syndrome in the same patient is increasing significantly

    Authors

    Abstract

    **Introduction**: Cancer patients have an increased risk of cardiovascular diseases and a significant prevalence of acute coronary syndrome (ACS). (1) The increased presence of cardiovascular risk factors in this environment has been shown to lead to an interaction between these two conditions, influencing their therapeutic strategies and contributing to higher mortality. Cancer patients have generally not been evaluated in ACS trials, so treatment in these cases is still not fully known. The reported prevalence of cancer among patients with ACS ranges between 3% and 17%. **Methods and Results**: We present the results of our observational study conducted from January 1 to December 1, 2022. The prevalence of cancer among patients with ACS who underwent percutaneous coronary intervention was about 11% (2% in active cancer treatment). The average age was 67 years and 73% were male patients. 42% of patients presented as an acute ST-elevation myocardial infarction. Intrahospital mortality was 2%. 64% of patient were treated with percutaneous coronary intervention and stents implantation. They were treated with dual antiplatelet therapy; in 70% ticagrelor, 17% prasugrel, others clopidogrel. It was found that prostate, lung, hematologic, colon, gynecologic and breast cancer are the most common types associated with ACS, which corresponds to our observations. **Conclusion**: Management of ACS in patients with cancer can be challenging because of frailty, increased bleeding risk, thrombocytopenia, increased thrombotic risk, and the possible need for future surgery/interventions. Percutaneous coronary intervention improves the survival rate of ACS patients, lowering early and late cardiac events. The presence of cancer should not limit the effective and safe treatment of ACS but requires a strict assessment of the risk of bleeding and thrombosis, in both cases with pharmacological and interventional treatment. Patients with concomitant cancer and coronary artery disease should be represented in ACS studies.

    Keywords

    acute coronary syndrome, cancer, cardio oncology

    DOI

    https://doi.org/10.15836/ccar2023.56

    Literature

    1. Lucà F, Parrini I, Abrignani MG, Rao CM, Piccioni L, Di Fusco SA, et al. Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It. J Clin Med. 2022 March 24;11(7):1792. https://doi.org/10.3390/jcm11071792
    Cardiologia Croatica
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    The incidence of cancer and acute coronary syndrome in the same patient is increasing significantly

    Extended Abstract
    Issue3-4
    Published
    Pages56
    PDF via DOIhttps://doi.org/10.15836/ccar2023.56
    acute coronary syndrome
    cancer
    cardio oncology

    Authors

    Marijana Knežević Praveček*ORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Krešimir GabaldoORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Domagoj MiškovićORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Ivan BitunjacORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Blaženka MiškićORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Katica Cvitkušić LukendaORCIDGeneral Hospital „Dr Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia

    *Correspondence email: marijana.pravecek@gmail.com

    Abstract

    **Introduction**: Cancer patients have an increased risk of cardiovascular diseases and a significant prevalence of acute coronary syndrome (ACS). (1) The increased presence of cardiovascular risk factors in this environment has been shown to lead to an interaction between these two conditions, influencing their therapeutic strategies and contributing to higher mortality. Cancer patients have generally not been evaluated in ACS trials, so treatment in these cases is still not fully known. The reported prevalence of cancer among patients with ACS ranges between 3% and 17%. **Methods and Results**: We present the results of our observational study conducted from January 1 to December 1, 2022. The prevalence of cancer among patients with ACS who underwent percutaneous coronary intervention was about 11% (2% in active cancer treatment). The average age was 67 years and 73% were male patients. 42% of patients presented as an acute ST-elevation myocardial infarction. Intrahospital mortality was 2%. 64% of patient were treated with percutaneous coronary intervention and stents implantation. They were treated with dual antiplatelet therapy; in 70% ticagrelor, 17% prasugrel, others clopidogrel. It was found that prostate, lung, hematologic, colon, gynecologic and breast cancer are the most common types associated with ACS, which corresponds to our observations. **Conclusion**: Management of ACS in patients with cancer can be challenging because of frailty, increased bleeding risk, thrombocytopenia, increased thrombotic risk, and the possible need for future surgery/interventions. Percutaneous coronary intervention improves the survival rate of ACS patients, lowering early and late cardiac events. The presence of cancer should not limit the effective and safe treatment of ACS but requires a strict assessment of the risk of bleeding and thrombosis, in both cases with pharmacological and interventional treatment. Patients with concomitant cancer and coronary artery disease should be represented in ACS studies.

    Literature

    1. 1.
      Lucà F, Parrini I, Abrignani MG, Rao CM, Piccioni L, Di Fusco SA, et al. Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It. J Clin Med. 2022 March 24;11(7):1792.DOI