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Current Atherosclerosis Reports

Erschienen in:

28.05.2022 | Coronary Heart Disease (S. Virani and M. Al Rifai, Section Editors)

Can We Mitigate Coronary Heart Disease Risk in Patients with Cancer?

verfasst von: Hasitha Manohar, Adam S. Potter, Efstratios Koutroumpakis, Anita Deswal, Nicolas L. Palaskas

Erschienen in: Current Atherosclerosis Reports | Ausgabe 8/2022

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Abstract

Purpose of Review

The review focuses on the shared risk factors observed between coronary heart disease and cancer, cancer therapeutics causing coronary heart disease, and potential strategies to mitigate atherosclerosis in patients with cancer.

Recent Findings

The pathophysiology behind how traditional cardiovascular risk factors also contribute to cancer development and mortality is increasingly recognized. In addition, newer cancer therapies, such as immune checkpoint inhibitors, cause increased inflammation leading to increased cardiovascular events.

Summary

Traditional coronary heart disease risk factors such as obesity, hypertension, diabetes, and hyperlipidemia also contribute to cancer development and worse cancer outcomes. Cancer therapeutics can also lead to atherosclerotic events in addition to the shared risk factors present at the time of cancer diagnosis. Understanding the pathophysiology, using multidisciplinary care teams, and developing machine learning algorithms for individualized patient care will help to mitigate the risk of coronary heart disease in patients with cancer.

World Health Organization: cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (2021). Accessed January 23, 2022.

Centers for Disease Control and Prevention: heart disease facts. https://www.cdc.gov/heartdisease/facts.htm (2021). Accessed January 23, 2022.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660.CrossRefPubMed

Centers for Disease Control and Prevention: deaths and mortality. https://www.cdc.gov/nchs/fastats/deaths.htm (2022). Accessed January 28, 2022.

Stoltzfus KC, Zhang Y, Sturgeon K, Sinoway LI, Trifiletti DM, Chinchilli VM, et al. Fatal heart disease among cancer patients. Nat Commun. 2020;11(1):2011. https://doi.org/10.1038/s41467-020-15639-5.CrossRefPubMedPubMedCentral

• Sturgeon KM, Deng L, Bluethmann SM, Zhou S, Trifiletti DM, Jiang C, et al. A population-based study of cardiovascular disease mortality risk in US cancer patients. Eur Heart J. 2019;40(48):3889–97. https://doi.org/10.1093/eurheartj/ehz766This article highlights the current trends in increased cardio vascular disease of patient swith cancer in the USA.CrossRefPubMedPubMedCentral

Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6–13. https://doi.org/10.1097/ede.0000000000000394.CrossRefPubMedPubMedCentral

Leiva O, AbdelHameid D, Connors JM, Cannon CP, Bhatt DL. Common pathophysiology in cancer, atrial fibrillation, atherosclerosis, and thrombosis. JACC: CardioOncology. 2021;3(5):619–34. https://doi.org/10.1016/j.jaccao.2021.08.011.CrossRefPubMedPubMedCentral

Arnold M, Pandeya N, Byrnes G, Renehan PAG, Stevens GA, Ezzati PM, et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol. 2015;16(1):36–46. https://doi.org/10.1016/s1470-2045(14)71123-4.CrossRefPubMed

10.

Global BMIMC, Di Angelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776–86. https://doi.org/10.1016/s0140-6736(16)30175-1.CrossRef

11.

Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78. https://doi.org/10.1016/s0140-6736(08)60269-x.CrossRefPubMed

12.

Ma Y, Yang Y, Wang F, Zhang P, Shi C, Zou Y, et al. Obesity and risk of colorectal cancer: a systematic review of prospective studies. PLoS ONE. 2013;8(1): e53916. https://doi.org/10.1371/journal.pone.0053916.CrossRefPubMedPubMedCentral

13.

Munsell MF, Sprague BL, Berry DA, Chisholm G, Trentham-Dietz A. Body mass index and breast cancer risk according to postmenopausal estrogen-progestin use and hormone receptor status. Epidemiol Rev. 2014;36(1):114–36. https://doi.org/10.1093/epirev/mxt010.CrossRefPubMedPubMedCentral

14.

Sanfilippo KM, McTigue KM, Fidler CJ, Neaton JD, Chang Y, Fried LF, et al. Hypertension and obesity and the risk of kidney cancer in 2 large cohorts of US men and women. Hypertension. 2014;63(5):934–41. https://doi.org/10.1161/hypertensionaha.113.02953.CrossRefPubMed

15.

Campbell PT, Newton CC, Freedman ND, Koshiol J, Alavanja MC, Beane Freeman LE, et al. Body mass index, waist circumference, diabetes, and risk of liver cancer for U.S. adults. Cancer Res. 2016;76(20):6076–83. https://doi.org/10.1158/0008-5472.Can-16-0787.CrossRefPubMedPubMedCentral

16.

Dougan MM, Hankinson SE, Vivo ID, Tworoger SS, Glynn RJ, Michels KB. Prospective study of body size throughout the life-course and the incidence of endometrial cancer among premenopausal and postmenopausal women. Int J Cancer. 2015;137(3):625–37. https://doi.org/10.1002/ijc.29427.CrossRefPubMedPubMedCentral

17.

Genkinger JM, Spiegelman D, Anderson KE, Bernstein L, van den Brandt PA, Calle EE, et al. A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. Int J Cancer. 2011;129(7):1708–17. https://doi.org/10.1002/ijc.25794.CrossRefPubMedPubMedCentral

18.

Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005;96(9):939–49. https://doi.org/10.1161/01.Res.0000163635.62927.34.CrossRefPubMed

19.

Hopkins BD, Goncalves MD, Cantley LC. Obesity and cancer mechanisms: cancer metabolism. J Clin Oncol. 2016;34(35):4277–83. https://doi.org/10.1200/jco.2016.67.9712.CrossRefPubMedPubMedCentral

20.

Kumar J, Fang H, McCulloch DR, Crowley T, Ward AC. Leptin receptor signaling via Janus kinase 2/signal transducer and activator of transcription 3 impacts on ovarian cancer cell phenotypes. Oncotarget. 2017;8(55):93530–40. https://doi.org/10.18632/oncotarget.19873.CrossRefPubMedPubMedCentral

21.

Sukocheva OA. Expansion of Sphingosine kinase and Sphingosine-1-phosphate receptor function in normal and cancer cells: from membrane restructuring to mediation of estrogen signaling and stem cell programming. Int J Mol Sci. 2018;19(2). https://doi.org/10.3390/ijms19020420.

22.

Johar R, Sharma R, Kaur A, Mukherjee TK. Role of reactive oxygen species in estrogen dependant breast cancer complication. Anticancer Agents Med Chem. 2015;16(2):190–9. https://doi.org/10.2174/1871520615666150518092315.CrossRefPubMed

23.

Domazetovic V, Fontani F, Marcucci G, Iantomasi T, Brandi ML, Vincenzini MT. Estrogen inhibits starvation-induced apoptosis in osteocytes by a redox-independent process involving association of JNK and glutathione S-transferase P1–1. FEBS Open Bio. 2017;7(5):705–18. https://doi.org/10.1002/2211-5463.12216.CrossRefPubMedPubMedCentral

24.

Casa AJ, Potter AS, Malik S, Lazard Z, Kuiatse I, Kim HT, et al. Estrogen and insulin-like growth factor-I (IGF-I) independently down-regulate critical repressors of breast cancer growth. Breast Cancer Res Treat. 2012;132(1):61–73. https://doi.org/10.1007/s10549-011-1540-0.CrossRefPubMed

25.

Koene RJ, Prizment AE, Blaes A, Konety SH. Shared risk factors in cardiovascular disease and cancer. Circulation. 2016;133(11):1104–14. https://doi.org/10.1161/CIRCULATIONAHA.115.020406.CrossRefPubMedPubMedCentral

26.

Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287(19):2570–81. https://doi.org/10.1001/jama.287.19.2570.CrossRefPubMed

27.

Kosmas CE, Silverio D, Tsomidou C, Salcedo MD, Montan PD, Guzman E. The impact of insulin resistance and chronic kidney disease on inflammation and cardiovascular disease. Clin Med Insights Endocrinol Diabetes. 2018;11:1179551418792257. https://doi.org/10.1177/1179551418792257.CrossRefPubMedPubMedCentral

28.

Semenkovich CF. Insulin resistance and atherosclerosis. J Clin Invest. 2006;116(7):1813–22. https://doi.org/10.1172/JCI29024.CrossRefPubMedPubMedCentral

29.

Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674–85. https://doi.org/10.2337/dc10-0666.CrossRefPubMedPubMedCentral

30.

Nakanishi R, Baskaran L, Gransar H, Budoff MJ, Achenbach S, Al-Mallah M, et al. Relationship of hypertension to coronary atherosclerosis and cardiac events in patients with coronary computed tomographic angiography. Hypertension (Dallas, Tex : 1979). 2017;70(2):293–9. https://doi.org/10.1161/HYPERTENSIONAHA.117.09402.CrossRefPubMedCentral

31.

Alexander RW. Hypertension and the pathogenesis of atherosclerosis. Hypertension. 1995;25(2):155–61. https://doi.org/10.1161/01.HYP.25.2.155.CrossRefPubMed

32.

Seretis A, Cividini S, Markozannes G, Tseretopoulou X, Lopez DS, Ntzani EE, et al. Association between blood pressure and risk of cancer development: a systematic review and meta-analysis of observational studies. Sci Rep. 2019;9(1):8565. https://doi.org/10.1038/s41598-019-45014-4.CrossRefPubMedPubMedCentral

33.

Felmeden DC, Spencer CG, Belgore FM, Blann AD, Beevers DG, Lip GY. Endothelial damage and angiogenesis in hypertensive patients: relationship to cardiovascular risk factors and risk factor management. Am J Hypertens. 2003;16(1):11–20. https://doi.org/10.1016/s0895-7061(02)03149-7.CrossRefPubMed

34.

Petrelli F, Ghidini A, Cabiddu M, Perego G, Lonati V, Ghidini M, et al. Effects of hypertension on cancer survival: a meta-analysis. Eur J Clin Invest. 2021;51(6): e13493. https://doi.org/10.1111/eci.13493.CrossRefPubMed

35.

• Ross R, Harker L. Hyperlipidemia and atherosclerosis. Science. 1976;193(4258):1094–100. https://doi.org/10.1126/science.822515This article is a meta-analysis combining numerous studies evaluating the effect of hypertensionon cancer outcomes.CrossRefPubMed

36.

Ross R. Atherosclerosis — an inflammatory disease. N Engl J Med. 1999;340(2):115–26. https://doi.org/10.1056/nejm199901143400207.CrossRefPubMed

37.

Yao X, Tian Z. Dyslipidemia and colorectal cancer risk: a meta-analysis of prospective studies. Cancer Causes Control. 2015;26(2):257–68. https://doi.org/10.1007/s10552-014-0507-y.CrossRefPubMed

38.

Ding X, Zhang W, Li S, Yang H. The role of cholesterol metabolism in cancer. Am J Cancer Res. 2019;9(2):219–27.PubMedPubMedCentral

39.

Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368(11):987–98. https://doi.org/10.1056/NEJMoa1209825.CrossRefPubMed

40.

Rastogi K, Sharma S, Gupta S, Agarwal N, Bhaskar S, Jain S. Dosimetric comparison of IMRT versus 3DCRT for post-mastectomy chest wall irradiation. Radiat Oncol J. 2018;36(1):71–8. https://doi.org/10.3857/roj.2017.00381.CrossRefPubMedPubMedCentral

41.

Wang X, Palaskas NL, Yusuf SW, Abe J-i, Lopez-Mattei J, Banchs J, et al. Incidence and onset of severe cardiac events after radiotherapy for esophageal cancer. Journal of Thoracic Oncology. 2020;15(10):1682–90. https://doi.org/10.1016/j.jtho.2020.06.014.CrossRefPubMed

42.

• Falco M, Masojć B, Macała A, Łukowiak M, Woźniak P, Malicki J. Deep inspiration breath hold reduces the mean heart dose in left breast cancer radiotherapy. Radiol Oncol. 2021;55(2):212–20. https://doi.org/10.2478/raon-2021-0008This is the largest single center cohort of 5-fluorouracil associated vasospasm.CrossRefPubMedPubMedCentral

43.

Zafar A, DrobniZsofia D, Mosarla R, Alvi Raza M, Lei M, Lou Uvette Y, et al. The incidence, risk factors, and outcomes with 5-fluorouracil–associated coronary vasospasm. JACC: CardioOncology. 2021;3(1):101–9. https://doi.org/10.1016/j.jaccao.2020.12.005.CrossRefPubMedPubMedCentral

44.

Tsavaris N, Kosmas C, Vadiaka M, Efremidis M, Zinelis A, Beldecos D, et al. Cardiotoxicity following different doses and schedules of 5-fluorouracil administration for malignancy – a survey of 427 patients. Med Sci Monit. 2002;8(6):PI51-7.PubMed

45.

Pandey AK, Singhi EK, Arroyo JP, Ikizler TA, Gould ER, Brown J, et al. Mechanisms of VEGF (vascular endothelial growth factor) inhibitor–associated hypertension and vascular disease. Hypertension. 2018;71(2):e1–8. https://doi.org/10.1161/HYPERTENSIONAHA.117.10271.CrossRefPubMed

46.

Cortes JE, Kim D-W, Pinilla-Ibarz J, le Coutre P, Paquette R, Chuah C, et al. A phase 2 trial of ponatinib in Philadelphia chromosome–positive leukemias. N Engl J Med. 2013;369(19):1783–96. https://doi.org/10.1056/NEJMoa1306494.CrossRefPubMed

47.

Caocci G, Mulas O, Abruzzese E, Luciano L, Iurlo A, Attolico I, et al. Arterial occlusive events in chronic myeloid leukemia patients treated with ponatinib in the real-life practice are predicted by the Systematic Coronary Risk Evaluation (SCORE) chart. Hematol Oncol. 2019;37(3):296–302. https://doi.org/10.1002/hon.2606.CrossRefPubMedPubMedCentral

48.

•• Drobni ZD, Alvi RM, Taron J, Zafar A, Murphy SP, Rambarat PK, et al. Association between immune checkpoint inhibitors with cardiovascular events and atherosclerotic plaque. Circulation. 2020;142(24):2299–311. https://doi.org/10.1161/CIRCULATIONAHA.120.049981This is one of the first studies with a control group to evaluate the increased incidence of atherosclerotic events in patients receiving immune checkpoint inhibitors.CrossRefPubMedPubMedCentral

49.

Bu DX, Tarrio M, Maganto-Garcia E, Stavrakis G, Tajima G, Lederer J, et al. Impairment of the programmed cell death-1 pathway increases atherosclerotic lesion development and inflammation. Arterioscler Thromb Vasc Biol. 2011;31(5):1100–7. https://doi.org/10.1161/atvbaha.111.224709.CrossRefPubMedPubMedCentral

50.

Cochain C, Chaudhari SM, Koch M, Wiendl H, Eckstein HH, Zernecke A. Programmed cell death-1 deficiency exacerbates T cell activation and atherogenesis despite expansion of regulatory T cells in atherosclerosis-prone mice. PLoS ONE. 2014;9(4): e93280. https://doi.org/10.1371/journal.pone.0093280.CrossRefPubMedPubMedCentral

51.

Poels K, van Leent MMT, Reiche ME, Kusters PJH, Huveneers S, de Winther MPJ, et al. Antibody-mediated inhibition of CTLA4 aggravates atherosclerotic plaque inflammation and progression in hyperlipidemic mice. Cells. 2020;9(9). https://doi.org/10.3390/cells9091987.

52.

Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2019;139(25):e1082–143. https://doi.org/10.1161/CIR.0000000000000625.CrossRefPubMed

53.

Newman TB, Hulley SB. Carcinogenicity of lipid-lowering drugs. JAMA. 1996;275(1):55–60.CrossRef

54.

Wang K, Gerke TA, Chen X, Prosperi M. Association of statin use with risk of Gleason score-specific prostate cancer: a hospital-based cohort study. Cancer Med. 2019;8(17):7399–407. https://doi.org/10.1002/cam4.2500.CrossRefPubMedPubMedCentral

55.

Martín García A, Mitroi C, Mazón Ramos P, García Sanz R, Virizuela JA, Arenas M, et al. Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC. Rev Esp Cardiol (Engl Ed). 2021;74(5):438–48. https://doi.org/10.1016/j.rec.2020.11.020.CrossRefPubMed

56.

Morze J, Danielewicz A, Przybyłowicz K, Zeng H, Hoffmann G, Schwingshackl L. An updated systematic review and meta-analysis on adherence to Mediterranean diet and risk of cancer. Eur J Nutr. 2021;60(3):1561–86. https://doi.org/10.1007/s00394-020-02346-6.CrossRefPubMed

57.

Jimenez-Torres J, Alcalá-Diaz JF, Torres-Peña JD, Gutierrez-Mariscal FM, Leon-Acuña A, Gómez-Luna P, et al. Mediterranean diet reduces atherosclerosis progression in coronary heart disease: an analysis of the CORDIOPREV randomized controlled trial. Stroke. 2021;52(11):3440–9. https://doi.org/10.1161/STROKEAHA.120.033214.CrossRefPubMed

58.

Gilchrist SC, Barac A, Ades PA, Alfano CM, Franklin BA, Jones LW, et al. Cardio-oncology rehabilitation to manage cardiovascular outcomes in cancer patients and survivors: a scientific statement from the American Heart Association. Circulation. 2019;139(21):e997–1012. https://doi.org/10.1161/cir.0000000000000679.CrossRefPubMedPubMedCentral

59.

Gilchrist SC, Howard VJ, Akinyemiju T, Judd SE, Cushman M, Hooker SP, et al. Association of sedentary behavior with cancer mortality in middle-aged and older US adults. JAMA Oncol. 2020;6(8):1210–7. https://doi.org/10.1001/jamaoncol.2020.2045.CrossRefPubMed

60.

Kim KH, Choi S, Kim K, Chang J, Kim SM, Kim SR, et al. Association between physical activity and subsequent cardiovascular disease among 5-year breast cancer survivors. Breast Cancer Res Treat. 2021;188(1):203–14. https://doi.org/10.1007/s10549-021-06140-8.CrossRefPubMed

61.

Lyon AR, Dent S, Stanway S, Earl H, Brezden-Masley C, Cohen-Solal A, et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. 2020;22(11):1945–60. https://doi.org/10.1002/ejhf.1920.CrossRefPubMed

62.

Curigliano G, Lenihan D, Fradley M, Ganatra S, Barac A, Blaes A, et al. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol. 2020;31(2):171–90. https://doi.org/10.1016/j.annonc.2019.10.023.CrossRefPubMed

63.

Bertsimas D, Orfanoudaki A, Weiner RB. Personalized treatment for coronary artery disease patients: a machine learning approach. Health Care Manag Sci. 2020;23(4):482–506. https://doi.org/10.1007/s10729-020-09522-4.CrossRefPubMed

Titel: Can We Mitigate Coronary Heart Disease Risk in Patients with Cancer?
verfasst von: Hasitha Manohar
Adam S. Potter
Efstratios Koutroumpakis
Anita Deswal
Nicolas L. Palaskas
Publikationsdatum: 28.05.2022
Verlag: Springer US
Erschienen in: Current Atherosclerosis Reports / Ausgabe 8/2022
Print ISSN: 1523-3804
Elektronische ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-022-01035-5

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