Abstract
Coronary heart disease (CHD) remains a leading cause of mortality among cancer patients, primarily due to shared risk factors and the impacts of chemotherapeutic drugs, immune checkpoint inhibitors, and radiotherapy. Determining the optimal treatment strategy remains a challenging issue for patients with concurrent CHD and malignant neoplasms. In high-risk patients, managing CHD frequently takes precedence over addressing the oncologic disease. Myocardial revascularization, coupled with optimal medical therapy for CHD, can significantly enhance patient survival by reducing the risks of myocardial infarction and sudden cardiac death. However, selecting a surgical treatment strategy requires careful consideration of the indications, the complexity of coronary lesions, the risk of bleeding and thrombosis, and the overall prognosis of the malignancy. This clinical case demonstrates the importance of risk-benefit assessment, multidisciplinary discussion of cure strategy, and application of novel technologies to provide the most personalized and effective treatment.
Reference20 articles.
1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74:229-63.
2. Davydov MI, Akchurin RS, Gerasimov SS, et al. Simultaneous surgery of competing cardio-vascular and malignant diseases of lungs and mediastinum. Khirurgiia 2010;8:4-10. [Article in Russian].
3. Rupprecht S, Finn S, Hoyer D, et al. Association between systemic inflammation, carotid arteriosclerosis, and autonomic dysfunction. Transl Stroke Res 2020;11:50-9.
4. Buziashvili YI, Asymbekova EU, Matskeplishvili ST, et al. Dynamics of echocardiographic parameters during neoadjuvant chemotherapy in patients with breast cancer. Creative Cardiology 2022;16:520-32.
5. Mamas MA, Brown SA, Sun LY. Coronary artery disease in patients with cancer: it's always the small pieces that make the bigger picture. Mayo Clin Proc 2020;95:1819-21.