Acute coronary syndrome in cancer patients. Part I: pathophysiology, clinical presentation and diagnosis

• Authors: Grzegorz Piotrowski
• Languages of publication: EN

Abstracts

EN

Coexistence of cardiovascular diseases and cancer is more and more common in everyday practice. This is due to the aging of the population and the fact that most of the classic cardiovascular risk factors also predispose to cancer. During anti-cancer treatment, cardiovascular components may be damaged and eventually lead to acute coronary syndrome. The first part of the review article presents the pathophysiology, clinical presentation and key elements of the diagnostic process of this life-threatening condition in cancer patients.

Keywords

EN

acute coronary syndrome; cardio-oncology; cardiotoxicity; cardiovascular complications; chemotherapy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OncoReview
• Year: 2020
• Volume: 10
• Issue: 2
• Pages: 41-47

Contributors

author

Grzegorz Piotrowski

• 1. Department of Cardio-Oncology, Medical University of Lodz, Poland. 2. Department of Cardiology, Provincial Multidisciplinary Oncology and Traumatology Center Nicolaus Copernicus, Lodz, Poland

References

• 1. World Health Organization. Global status report on noncommunicable disease 2010. Geneva, Switzerland 2011. http://apps.who.int/iris/bitstream/ handle/10665/44579/9789240686458_eng.pdf.
• 2. de Moor JS, Mariotto AB, Parry C et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev. 2013; 22(4): 561-70.
• 3. Stewart S, MacIntyre K, Hole DJ et al. More 'malignant' than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 200; 3(3): 315-22.
• 4. Zamorano JL, Lancellotti P, Rodriguez Muñoz D et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016; 37(36): 2768-801.
• 5. Dreyer L, Olsen JH. Cancer risk of patients discharged with acute myocardial infarct. Epidemiology. 1998; 9(2): 178-83.
• 6. Zoller B, Ji J, Sundquist J et al. Risk of coronary heart disease in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer. 2012; 48(1): 121-8.
• 7. Weaver KE, Foraker RE, Alfano CM et al. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care? J Cancer Surviv. 2013; 7(2): 253-61.
• 8. Iliescu CA, Grines CL, Herrmann J et al. SCAI Expert consensus statement: Evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (endorsed by the cardiological society of India, and sociedad Latino Americana de Cardiologıa intervencionista). Catheter Cardiovasc Interv. 2016; 87(5): E202-23.
• 9. Chen HY, Saczynski JS, McManus DD et al. The impact of cardiac and noncardiac comorbidities on the short-term outcomes of patients hospitalized with acute myocardial infarction: a population-based perspective. Clin Epidemiol. 2013; 5: 439-48.
• 10. Potts JE, Iliescu CA, Lopez Mattei JC et al. Percutaneous coronary intervention in cancer patients: a report on the prevalence and outcomes in the United States. Eur Heart J. 2019; 40: 1790-800.
• 11. Pavo N, Raderer M, Hülsmann M et al. Cardiovascular biomarkers in patients with cancer and their association with all-cause mortality. Heart. 2015; 101(23): 1874-80.
• 12. Ameri P, Canepa M, Anker MS et al. Cancer diagnosis in patients with heart failure: epidemiology, clinical implications and gaps in knowledge. Eur J Heart Fail. 2018; 20(5): 879-87.
• 13. Malmborg M, Christiansen CB, Schmiegelow MD et al. Incidence of new onset cancer in patients with a myocardial infarction – a nationwide cohort study. BMC Cardiovasc Disord. 2018; 18(1): 198.
• 14. Demers M, Krause DS, Schatzberg D et al. Cancers predispose neutrophils to release extracellular DNA traps that contribute to cancer-associated thrombosis. Proc Natl Acad Sci U S A. 2012; 109(32): 13076-81.
• 15. Blann AD, Dunmore S. Arterial and venous thrombosis in cancer patients. Cardiol Res Pract. 2011; 2011: 394740.
• 16. Nelson ER, Wardell SE, Jasper JS et al. 27-Hydroxycholesterol links hypercholesterolemia and breast cancer pathophysiology. Science. 201; 342(6162): 1094-8.
• 17. Jaiswal S, Natarajan P, Silver AJ et al. Clonal Hematopoiesis and Risk of Atherosclerotic. N Engl J Med. 2017; 377(2): 111-21.
• 18. Jaiswal S, Natarajan P, Ebert BL. Clonal Hematopoiesis and Atherosclerosis. N Engl J Med. 2017; 377(14): 1401-2.
• 19. Toya T, Sara JD, Corban MT et al. Assessment of peripheral endothelial function predicts future risk of solid-tumor cancer. Eur J Prev Cardiol. 2019; 27(60): 608-18. http://doi.org/10.1177/2047487319884246.
• 20. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004; 109(23 suppl 1): III27-III32.
• 21. Herrmann J, Lerman A. An update on cardio-oncology. Trends Cardiovasc Med. 2014; 24(7): 285-95.
• 22. Wang JC, Normand SL, Mauri L et al. Coronary artery spatial distribution of acute myocardial infarction occlusions. Circulation. 2004; 110(3): 278-84.
• 23. Herrmann J. Clinical Cardio-oncology. Elsevier, Phyladelphia 2017: 173.
• 24. Cortes JE, Kim DW, Pinilla-Ibarz J et al. A phase 2 trial of ponatinib in Philadelphia chromosome-positive leukemias. N Engl J Med. 2013; 369(19): 1783-96.
• 25. Cortes JE, Kantarjian H, Shah NP et al. Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med. 2012; 367(22): 2075-88.
• 26. Nicolini FE, Gagnieu MC, Heiblig M et al. Cardio-vascular events occurring on ponatinib in chronic phase chronic myeloid leukemia patients, preliminary analysis of a multicenter cohort. Blood. 2013; 122(21): 4020.
• 27. Levato L, Cantaffa R, Kropp MG et al. Progressive peripheral arterial occlusive disease and other vascular events during nilotinib therapy in chronic myeloid leukemia: a single institution study. Eur J Haematol. 2013; 90(6): 531-2.
• 28. Chislock EM, Ring C, Pendergast AM. Abl kinases are required for vascular function, Tie2 expression, and angiopoietin-1-mediated survival. Proc Natl Acad Sci U S A. 2013; 110(30): 12432-7.
• 29. Berliner S, Rahima M, Sidi Y et al. Acute coronary events following cisplatin-based chemotherapy. Cancer Invest. 1990; 8(6): 583-6.
• 30. Jafri M, Protheroe A. Cisplatin-associated thrombosis. Anticancer Drugs. 2008; 19(9): 927-9.
• 31. Karabay KO, Yildiz O, Aytekin V. Multiple coronary thrombi with cisplatin. J Invasive Cardiol. 2014; 26(2): E18-20.
• 32. Togna GI, Togna AR, Franconi M et al. Cisplatin triggers platelet activation. Thromb Res. 2000; 99(5): 503-9.
• 33. Oh JH, Baum DD, Pham S et al. Long-term complications of platinum-based chemotherapy in testicular cancer survivors. Med Oncol. 2007; 24(2): 175-81.
• 34. Winnik S, Lohmann C, Siciliani G et al. Systemic VEGF inhibition accelerates experimental atherosclerosis and disrupts endothelial homeostasis – implications for cardiovascular safety. Int J Cardiol. 2013; 168(3): 2453-61.
• 35. Kappers MH, van Esch JH, Sluiter W et al. Hypertension induced by the tyrosine kinase inhibitor sunitinib is associated with increased circulating endothelin-1 levels. Hypertension. 2010; 56(4): 675-81.
• 36. Kappers MH, Smedts FM, Horn T et al. The vascular endothelial growth factor receptor inhibitor sunitinib causes a preeclampsia-like syndrome with activation of the endothelin system. Hypertension. 2011; 58(2): 295-302.
• 37. Kappers MH, de Beer VJ, Zhou Z et al. Sunitinib-induced systemic vasoconstriction in swine is endothelin mediated and does not involve nitric oxide or oxidative stress. Hypertension. 2012; 59(1): 151-7.
• 38. Chintalgattu V, Rees ML, Culver JC et al. Coronary microvascular pericytes are the cellular target of sunitinib malate-induced cardiotoxicity. Sci Transl Med. 2013; 5(187): 187ra69.
• 39. de Boer MP, van der Veldt AA, Lankheet NA et al. Sunitinib-induced reduction in skin microvascular density is a reversible phenomenon. Ann Oncol. 2010; 21(9): 1923-4.
• 40. van der Veldt AA, de Boer MP, Boven E et al. Reduction in skin microvascular density and changes in vessel morphology in patients treated with sunitinib. Anticancer Drugs. 2010; 21(4): 439-46.
• 41. Südhoff T, Enderle MD, Pahlke M et al. 5-Fluorouracil induces arterial vasocontractions. Ann Oncol. 2004; 15(4): 661-4.
• 42. Cerny J, Hassan A, Smith C et al. Coronary vasospasm with myocardial stunning in a patient with colon cancer receiving adjuvant chemotherapy with FOLFOX regimen. Clin Colorectal Cancer. 2009; 8(1): 55-8.
• 43. Ambrosy AP, Kunz PL, Fisher GA et al. Capecitabine-induced chest pain relieved by diltiazem. Am J Cardiol. 2012; 110(11): 1623-6.
• 44. Stewart T, Pavlakis N, Ward M. Cardiotoxicity with 5-fluorouracil and capecitabine: more than just vasospastic angina. Intern Med J. 2010; 40(4): 303-7.
• 45. Polk A, Vistisen K, Vaage-Nilsen M et al. A systematic review of the pathophysiology of 5-fluorouracil-induced cardiotoxicity. BMC Pharmacol Toxicol. 2014; 15: 47.
• 46. Jensen SA, Sørensen JB. Risk factors and prevention of cardiotoxicity induced by 5-fluorouracil or capecitabine. Cancer Chemother Pharmacol. 2006; 58(4): 487-93.
• 47. Polk A, Vistisen K, Vaage-Nilsen M et al. Cardiotoxicity in cancer patients treated with 5-fluorouracil or capecitabine: a systematic review of incidence, manifestations and predisposing factors. Cancer Treat Rev. 2013; 39(8): 974-84.
• 48. Juan YH, Chatzizisis YS, Saboo SS et al. Tumor encasement of the right coronary artery: role of anatomic and functional imaging in diagnosis and therapeutic management. Open Cardiovasc Med J. 2014; 8: 110-2.
• 49. Thygesen K, Alpert JS, Jaffe AS et al. [Fourth universal definition of myocardial infarction (2018)]. Kardiol Pol. 2018; 76(10): 1383-415.
• 50. Singh A, Gupta A, DeFilippis EM et al. Cardiovascular Mortality After Type 1 and Type 2 Myocardial Infarction in Young Adults. J Am Coll Cardiol. 2020; 75(9): 1003-13.
• 51. Yusuf SW, Daraban N, Abbasi N et al. Treatment and outcomes of acute coronary syndrome in the cancer population. Clin Cardiol. 2012; 35(7): 443-50.
• 52. Piotrowski G, Pszonicka K, Paradowska E et al. Global Cardio-Oncology Summit. Vancouver 2015.
• 53. Ibanez B, James S, Agewall S et al. ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39(2): 119-77.
• 54. Roffi M, Patrono C, Collet JP et al. ESC Scientific Document Group. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016; 37(3): 267-315.

• Document Type: article