Oren Ohad, Herrmann Joerg
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
J Thorac Dis. 2018 Dec;10(Suppl 35):S4367-S4385. doi: 10.21037/jtd.2018.12.79.
Patients with cancer are at high risk for both venous and arterial thrombotic complications. A variety of factors account for the greater thrombotic risk, including the underlying malignancy and numerous cancer-directed therapies. The occurrence of an acute thrombotic event in patients with cancer is associated with substantial morbidity and mortality. Acute coronary syndrome (ACS) represents a particularly important cardiovascular complication in cancer patients. With cardio-vascular risk factors becoming more prevalent in an aging cancer population that is surviving longer, questions pertaining to the appropriate management of vascular toxicity are likely to assume even greater value in the coming years. In this article, we review the current understanding of ACS in patients with cancer. The predisposition to thrombosis in a malignant host and the cancer treatments most commonly associated with vascular toxicity are reviewed. Risk prediction and management strategies are discussed, and discrepancies in the clinical evidence are highlighted.
癌症患者发生静脉和动脉血栓并发症的风险很高。多种因素导致了更高的血栓形成风险，包括潜在的恶性肿瘤和众多针对癌症的治疗方法。癌症患者发生急性血栓事件与严重的发病率和死亡率相关。急性冠状动脉综合征（ACS）是癌症患者中一种特别重要的心血管并发症。随着心血管危险因素在存活时间更长的老年癌症人群中变得更加普遍，与血管毒性的适当管理相关的问题在未来几年可能会具有更大的价值。在本文中，我们综述了目前对癌症患者急性冠状动脉综合征的认识。回顾了恶性宿主中血栓形成的易感性以及最常与血管毒性相关的癌症治疗方法。讨论了风险预测和管理策略，并强调了临床证据中的差异。
