Myocardial Ischemia Related to Common Cancer Therapy—Prevention Insights

Abstract

Modern antineoplastic therapy improves survival and quality of life in cancer patients, but its indisputable benefits are accompanied by multiple and major side effects, such as cardiovascular ones. Endothelial dysfunction, arterial spasm, intravascular thrombosis, and accelerated atherosclerosis affect the coronary arteries, leading to acute and chronic coronary syndromes that negatively interfere with the oncologic treatment. The cardiac toxicity of antineoplastic agents may be mitigated by using adequate prophylactic measures. In the absence of dedicated guidelines, our work provides the most comprehensive, systematized, structured, and up-to-date analyses of the available literature focusing on measures aiming to protect the coronary arteries from the toxicity of cancer therapy. Our work facilitates the implementation of these measures in daily practice. The ultimate goal is to offer clinicians the necessary data for a personalized therapeutic approach for cancer patients receiving evidence-based oncology treatments with potential cardiovascular toxicity.

Ischemic Heart Disease in the Context of Different Comorbidities

“…Cancer is highly prevalent in the elderly, and cardiac toxicity of antineoplastic agents is currently a topic of major interest. Badescu et al have shown that some commonly used oncological treatments have adverse effects on coronary arteries, as they induce endothelial dysfunction, coronary artery spasm, thrombosis, and fibrosis [ 6 ]. These harmful structural and functional changes lead to cardiovascular events that require reduction or temporary or permanent stop of antineoplastic therapy, and all of these events have a negative impact on cancer outcomes.…”