TY - JOUR
T1 - Mechanisms of Myocardial Ischemia in Cancer Patients
T2 - A State-of-the-Art Review of Obstructive Versus Non-Obstructive Causes
AU - Balanescu, Dinu V.
AU - Bloomingdale, Richard
AU - Donisan, Teodora
AU - Yang, Eric H.
AU - Parwani, Purvi
AU - Iliescu, Cezar
AU - Herrmann, Joerg
AU - Hanson, Ivan
N1 - Publisher Copyright:
© 2022 The Author(s). Published by IMR Press. This is an open access article under the CC BY 4.0 license.
PY - 2022
Y1 - 2022
N2 - In patients with cancer, myocardial infarction (MI) has distinct features and mechanisms compared to the non-oncology population. Triggers of myocardial ischemia specific to the oncology population have been increasingly identified. Coronary plaque disruption, coronary vasospasm, coronary microvascular dysfunction, spontaneous coronary artery dissection, and coronary oxygen supply-demand mismatch are all causes of MI that have been shown to have specific triggers related to either the treatments or complications of cancer. MI can occur in the presence or absence of atherosclerotic coronary artery disease (CAD). MI with nonobstructive CAD (MINOCA) is a heterogeneous syndrome that has distinct pathophysiology and different epidemiology from MI with significant CAD (MI-CAD). Recognition and differentiation of MI-CAD and MINOCA is essential in the oncology population, due to unique etiology and impact on diagnosis, management, and overall outcomes. There are currently no reports in the literature concerning MINOCA as a unified syndrome in oncology patients. The purpose of this review is to analyze the literature for studies related to known triggers of myocardial ischemia in cancer patients, with a focus on MINOCA. We propose that certain cancer treatments can induce MINOCA-like states, and further research is warranted to investigate mechanisms that may be unique to certain cancer states and types of treatment.
AB - In patients with cancer, myocardial infarction (MI) has distinct features and mechanisms compared to the non-oncology population. Triggers of myocardial ischemia specific to the oncology population have been increasingly identified. Coronary plaque disruption, coronary vasospasm, coronary microvascular dysfunction, spontaneous coronary artery dissection, and coronary oxygen supply-demand mismatch are all causes of MI that have been shown to have specific triggers related to either the treatments or complications of cancer. MI can occur in the presence or absence of atherosclerotic coronary artery disease (CAD). MI with nonobstructive CAD (MINOCA) is a heterogeneous syndrome that has distinct pathophysiology and different epidemiology from MI with significant CAD (MI-CAD). Recognition and differentiation of MI-CAD and MINOCA is essential in the oncology population, due to unique etiology and impact on diagnosis, management, and overall outcomes. There are currently no reports in the literature concerning MINOCA as a unified syndrome in oncology patients. The purpose of this review is to analyze the literature for studies related to known triggers of myocardial ischemia in cancer patients, with a focus on MINOCA. We propose that certain cancer treatments can induce MINOCA-like states, and further research is warranted to investigate mechanisms that may be unique to certain cancer states and types of treatment.
KW - MINOCA
KW - cancer
KW - cardio-oncology
KW - myocardial infarction in the absence of obstructive coronary artery disease
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U2 - 10.31083/J.RCM2307227
DO - 10.31083/J.RCM2307227
M3 - Review article
AN - SCOPUS:85133963935
SN - 1530-6550
VL - 23
JO - Reviews in cardiovascular medicine
JF - Reviews in cardiovascular medicine
IS - 7
M1 - 227
ER -