The Intersection of Cancer and Cardiovascular Disease

By Vlad Zaha, M.D., Ph.D.
Assistant Professor of Internal Medicine

The intersection of cancer and cardiovascular disease is increasingly recognized in clinical practice. While clinical guidelines are yet emerging, a wide range of cardiovascular implica­tions of cancer and cancer therapies pose challeng­es in equal measure to hematology-oncology and cardiology practitioners. Therefore, patients benefit from an emerging specialized dual cardiologic and hemato-oncologic perspective. A rich collection of established paradigms and novel developments in this bridging clinical and scientific area was presented at this year’s AHA Scientific Sessions.

State-of-the-art discussions included cancer therapies and their cardiovascular risks, vascu­lar biology and cancer, and novel mechanisms of cardiovascular toxicity in cancer and cancer therapeutics. Several original basic, translational, and epidemiologic research studies have been centered in this area.

The 2018 AHA Scientific Sessions revealed the current breadth and depth of understanding of cardio-oncologic issues. In summary, the main topics included:

• The association of atherosclerotic cardiovascular disease risk with cancer, cardiovascular disease, and mortality
  
• The intersection of cardiovascular disease and breast cancer
  
• Remodeling of the cardiac myocyte proteome and metabolome under the effect of the oncometabolite alpha-ketoglutarate
  
• Management of chemotherapeutic-related hypertension
  
• Myocardial infarction and vasospasm in patients with cancer
  
• Venous thrombosis and cancer
  
• Fibrinolytic therapy in patients with pulmonary embolism and cancer
  
• Pulmonary hypertension induced by anti-cancer therapy
  
• Clonal hematopoiesis and the risk of cardiovascular disease
  
• Immune checkpoint-inhibitor cardiomyopathy
  
• The impact of cancer on contemporary heart failure management
  

This comprehensive coverage offered partici­pants firsthand access to interact with several experts in the different cardio-oncology areas and a perspective on the leading-edge research in this bridging field.