SCAI releases expert consensus statement on cardiac catheterization of cancer patients

With more cancer patients being exposed to radiation and chemotherapy and potential cardiovascular complications, the Society for Cardiovascular Angiography and Interventions (SCAI) released an expert consensus statement on the cardiac catheterization of cancer patients.

The researchers noted that cancer therapies could lead to angina, acute coronary syndrome, stroke, critical limb ischemia, arrhythmias and heart failure independent from the typical direct myocardial or pericardial damage. They added that cancer increases the risk of acute thrombotic events.

However, cancer patients are typically excluded from randomized PCI trials and national PCI registries, so data on the cardiovascular complications of cancer patients in the catheterization laboratory is limited.

Lead researcher Cezar A. Iliescu, MD, FSCAI, of the MD Anderson Cancer Center in Houston, and colleagues published the statement online in Catheterization and Cardiovascular Interventions.

They mentioned that there are approximately 14.5 million cancer survivors in the U.S., a number that is expected to increase to 20 million by 2020. They also noted that radiation and chemotherapy might be associated with cardiovascular toxicity.

For this consensus statement, SCAI convened a writing committee of 10 physicians who reviewed the medical literature to provide recommendations. They also considered the expertise of operators with experience treating cancer patients in the cardiac catheterization laboratory.

The consensus statement included information on the mechanisms of vascular toxicities in cancer patients, non-coronary interventional procedures in cancer patients, aortic valvuloplasty, transcatheter aortic valve implantation and other aspects of cardiovascular care.

“The cardio-oncology patient population has been increasing in recent years, with better quality of life and improved survival rates,” the researchers wrote. “Invasive cardiac assessment is important for the evaluation and management of concomitant heart disease. This SCAI consensus document aims to indicate special considerations to be addressed by interventional cardiologists when managing this frail patient subgroup. Collaboration between cardiologists and hematologists/oncologists is of prime importance. Further research involving cancer patients is also needed to optimize the care of oncology patients in the [cardiac catheterization laboratory].”