Drug-Eluting Stents: Their Preventative/Prophylactic Role Against Gemcitabine Induced Acute Coronary Syndrome

Jaafar A Hamdan; Kerolos N Youssef; Aafreen Khan; Mohammed A Abdalla; Christine M Zakhary; Hiam Rushdi; Safeera Khan

doi:10.7759/cureus.16384

Drug-Eluting Stents: Their Preventative/Prophylactic Role Against Gemcitabine Induced Acute Coronary Syndrome

Cureus. 2021 Jul 14;13(7):e16384. doi: 10.7759/cureus.16384. eCollection 2021 Jul.

Authors

Jaafar A Hamdan^{1

2}, Kerolos N Youssef², Aafreen Khan², Mohammed A Abdalla², Christine M Zakhary², Hiam Rushdi³, Safeera Khan²

Affiliations

¹ Medicine, American University of Antigua, St. John, ATG.
² Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
³ Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Abstract

Acute coronary syndrome (ACS), a subdivision of ischemic cardiac disease, is the sudden occlusion of coronary vessels that results in decreased blood supply to heart muscles and possible infarction. Though some of the etiologies are hypertension, hyperlipidemia, diabetes mellitus, and tobacco; certain types of chemotherapies play a major role. Percutaneous coronary intervention (PCI) has shown lifesaving results via drug-eluting stent (DES) deployment into occluded vessels. In this study, DES utilization among patients receiving chemotherapy will be assessed to observe if it provides any prevention against ACS. Articles were systematically screened in three databases such as PubMed, PubMed Central (PMC), and Medical Literature Analysis and Retrieval System Online (MEDLINE) using keywords and Medical Subject Heading (MeSH) terms for applicable articles. Additionally, a few relevant articles from the Cochrane Library, Molecular Diversity Preservation International (MDPI), and The New England Journal of Medicine were also used. Inclusion/exclusion criteria were applied post article screening via title and abstracts. Quality appraisal check was done using the Scale for the Assessment of Narrative Review Articles (SANRA) checklist, A Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist, Cochrane bias assessment tool, and Joanna Briggs Institute (JBI) checklist. Ten related studies were strictly reviewed. DES did not appear to play a preventable role against ACS during chemotherapy as no study was found assessing DES prophylactically and its efficacy in cancer patients. Future clinical trials on DES prophylactic use might be beneficial to evaluate if ACS adversities of chemotherapy can be prevented. This review is of significant benefit as cardiovascular adversities would not impede chemotherapy efficacy as cardiac adversities would not be part of the equation.

Keywords: 5 fluorouracil; acute coronary syndrome; capecitabine; chemotherapy-related toxicity; coronary artery vasospasm; drug eluting stents; gemcitabine; interventional cardiology; primary percutaneous coronary intervention (pci).

Publication types

Review