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介入心脏病学与肿瘤学:高危人群中的独特挑战与注意事项。

Interventional Cardio-Oncology: Unique Challenges and Considerations in a High-Risk Population.

机构信息

Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.

Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.

出版信息

Curr Treat Options Oncol. 2023 Aug;24(8):1071-1087. doi: 10.1007/s11864-023-01110-2. Epub 2023 Jun 10.

Abstract

Patients with cancer are at risk of developing cardiovascular disease (CVD) including atherosclerotic heart disease (AHD), valvular heart disease (VHD), and atrial fibrillation (AF). Advances in percutaneous catheter-based treatments, including percutaneous coronary intervention (PCI) for AHD, percutaneous valve replacement or repair for VHD, and ablation and left atrial appendage occlusion devices (LAAODs) for AF, have provided patients with CVD significant benefit in the recent decades. However, trials and registries investigating outcomes of these procedures often exclude patients with cancer. As a result, patients with cancer are less likely to undergo these therapies despite their benefits. Despite the inclusion of cancer patients in randomized clinical trial data, studies suggest that cancer patients derive similar benefits of percutaneous therapies for CVD compared with patients without cancer. Therefore, percutaneous interventions for CVD should not be withheld in patients with cancer, as they may still benefit from these procedures.

摘要

癌症患者面临发生心血管疾病(CVD)的风险,包括动脉粥样硬化性心脏病(AHD)、心脏瓣膜病(VHD)和心房颤动(AF)。经皮导管介入治疗的进步,包括 AHD 的经皮冠状动脉介入治疗(PCI)、VHD 的经皮瓣膜置换或修复以及 AF 的消融和左心耳封堵装置(LAAOD),为 CVD 患者带来了显著的益处。然而,研究这些手术结果的试验和注册研究往往排除了癌症患者。因此,尽管这些治疗方法有好处,但癌症患者进行这些治疗的可能性较小。尽管癌症患者被纳入随机临床试验数据,但研究表明,癌症患者从 CVD 的经皮治疗中获得的益处与无癌症患者相似。因此,不应拒绝癌症患者接受 CVD 的经皮介入治疗,因为他们可能仍能从这些治疗中获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40a7/10356652/124f3800c989/11864_2023_1110_Fig1_HTML.jpg

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