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

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.

Keywords: Atrial fibrillation; Atrial fibrillation ablation; Cardio-oncology; Left atrial appendage occlusion; Percutaneous coronary intervention; Transcatheter valve replacement.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation* / drug therapy
  • Atrial Fibrillation* / surgery
  • Heart Valve Diseases* / epidemiology
  • Heart Valve Diseases* / surgery
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / therapy
  • Percutaneous Coronary Intervention* / adverse effects
  • Randomized Controlled Trials as Topic
  • Risk Factors