Dual Antiplatelet Therapy and Cancer; Balancing between Ischemic and Bleeding Risk: A Narrative Review

Author:

Tsigkas Grigorios1ORCID,Vakka Angeliki1ORCID,Apostolos Anastasios12ORCID,Bousoula Eleni3,Vythoulkas-Biotis Nikolaos1ORCID,Koufou Eleni-Evangelia1ORCID,Vasilagkos Georgios1ORCID,Tsiafoutis Ioannis4,Hamilos Michalis5,Aminian Adel6ORCID,Davlouros Periklis1

Affiliation:

1. Department of Cardiology, University Hospital of Patras, 265 04 Patras, Greece

2. First Department of Cardiology, Hippocration General Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece

3. Department of Cardiology, Tzaneio General Hospital, 185 36 Piraeus, Greece

4. First Department of Cardiology, Red Cross Hospital, 115 26 Athens, Greece

5. Department of Cardiology, Heraklion University Hospital, 715 00 Heraklion, Crete, Greece

6. Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, 6042 Charleroi, Belgium

Abstract

Cardiovascular (CV) events in patients with cancer can be caused by concomitant CV risk factors, cancer itself, and anticancer therapy. Since malignancy can dysregulate the hemostatic system, predisposing cancer patients to both thrombosis and hemorrhage, the administration of dual antiplatelet therapy (DAPT) to patients with cancer who suffer from acute coronary syndrome (ACS) or undergo percutaneous coronary intervention (PCI) is a clinical challenge to cardiologists. Apart from PCI and ACS, other structural interventions, such as TAVR, PFO-ASD closure, and LAA occlusion, and non-cardiac diseases, such as PAD and CVAs, may require DAPT. The aim of the present review is to review the current literature on the optimal antiplatelet therapy and duration of DAPT for oncologic patients, in order to reduce both the ischemic and bleeding risk in this high-risk population.

Publisher

MDPI AG

Subject

Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics

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