Etiologies of coronary artery disease in cancer patients. [Review of CAD induced by cardiac metastases, radiotherapy, and chemotherapy]

Journal Article · Sun Jan 01 04:00:00 EST 1978 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(78)90053-6· OSTI ID:6858562

Kopelson, G; Herwig, K J

The growing number of patient reports of angina and myocardial infarction during cancer management prompted this review of coronary artery disease (CAD) in cancer patients. There is no definite evidence that cancer per se nor any particular tumor type predisposes to coronary atherosclerosis. Cardiac metastases can cause CAD via tumor emboli, extrinsic compression, or ostial obstruction; in these patients the diagnosis of CAD as a result of cardiac metastases often is not made until death. The course of these patients usually is fulminant. Tumor-associated coagulation disorders and non-bacterial thrombotic endocarditis can cause coronary thromboemboli; treatment should be initiated early as these patients often are not in a terminal state when such CAD develops. Post-radiation CAD seen in experimental animals (via fibrosis and/or accelerated atherogenesis) can be extrapolated to the clinical situation. This is best evidenced by 10 young patients, with minimal coronary risk factors in most, who developed angina and/or myocardial infarction 2 to 100 months after chest radiotherapy; approximate mediastinal doses ranged from 1440 Roentgen to 5075 rad. In 5 patients there was no significant atherosclerosis beyond the radiation portals; 2 had successful saphenous vein bypass grafts. Lipid-lowering therapy may prevent post-radiotherapy atherogenesis in high risk individuals. Chemotherapy (acting directly or synergistically with radiotherapy) has caused angina and myocardial infarction within hours to days after the infusion of agents both classically cardiotoxic as well as others, although the exact mechanism(s) for coronary artery damage as a result of chemotherapy presently is unknown.

• OSTI ID: 6858562
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 4:9/10; ISSN IOBPD
• Country of Publication: United States
• Language: English

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550900 -- Pathology
560151* -- Radiation Effects on Animals-- Man
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANTINEOPLASTIC DRUGS
ARTERIES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BLOOD VESSELS
BODY
BODY AREAS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMOTHERAPY
CHEST
CORONARIES
DELAYED RADIATION EFFECTS
DISEASES
DOCUMENT TYPES
DRUGS
EARLY RADIATION EFFECTS
ETIOLOGY
EXTERNAL IRRADIATION
HEART
IONIZING RADIATIONS
IRRADIATION
MEDICINE
METASTASES
MYOCARDIAL INFARCTION
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PARTIAL BODY IRRADIATION
PATIENTS
RADIATION EFFECTS
RADIATIONS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
REVIEWS
SIDE EFFECTS
THERAPY