Interventional cardiology in cancer patients: A position paper from the Portuguese Cardiovascular Intervention Association and the Portuguese Cardio-Oncology Study Group of the Portuguese Society of Cardiology

Rev Port Cardiol. 2024 Jan;43(1):35-48. doi: 10.1016/j.repc.2023.04.013. Epub 2023 Jul 22.
[Article in English, Portuguese]

Abstract

The field of Cardio-Oncology has grown significantly, especially during the last decade. While awareness of cardiotoxicity due to cancer disease and/or therapies has greatly increased, much of the attention has focused on myocardial systolic disfunction and heart failure. However, coronary and structural heart disease are also a common issue in cancer patients and encompass the full spectrum of cardiotoxicity. While invasive percutaneous or surgical intervention, either is often needed or considered in cancer patients, limited evidence or guidelines are available for dealing with coronary or structural heart disease. The Society for Cardiovascular Angiography and Interventions consensus document published in 2016 is the most comprehensive document regarding this particular issue, but relevant evidence has emerged since, which render some of its considerations outdated. In addition to that, the recent 2022 ESC Guidelines on Cardio-Oncology only briefly discuss this topic. As a result, the Portuguese Association of Cardiovascular Intervention and the Cardio-Oncology Study Group of the Portuguese Society of Cardiology have partnered to produce a position paper to address the issue of cardiac intervention in cancer patients, focusing on percutaneous techniques. A brief review of available evidence is provided, followed by practical considerations. These are based both on the literature as well as accumulated experience with these types of patients, as the authors are either interventional cardiologists, cardiologists with experience in the field of Cardio-Oncology, or both.

Keywords: Acute coronary syndrome; Aortic stenosis; Cardio-Oncologia; Cardio-Oncology; Chronic coronary syndrome; Comissurotomia mitral percutânea; Coronary artery disease; Doença cardíaca estrutural; Doença coronária; Doença valvular; Encerramento percutâneo de apêndice auricular esquerdo; Estenose aórtica; Implantação percutânea de válvula aórtica; Intervenção coronária percutânea; Left atrial appendage occlusion; Mitral regurgitation; Percutaneous coronary intervention; Percutaneous mitral valve commissurotomy; Regurgitação mitral; Structural heart disease; Síndrome coronária aguda; Síndrome coronária crónica; Transcatheter aortic valve implantation; Valvular heart disease.

Publication types

  • Practice Guideline

MeSH terms

  • Cardio-Oncology
  • Cardiology*
  • Cardiotoxicity
  • Heart Diseases*
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / therapy
  • Percutaneous Coronary Intervention*
  • Portugal