An expert consensus statement has been released by the Society for Cardiovascular Angiography and Interventions (SCAI), intended to provide cardiologists, oncologists and internal medicine physicians with guidance for treating patients facing both cardiovascular disease and cancer.
The statement has been published in Catheterization and Cardiovascular Interventions (CCI), and is endorsed by the Cardiological Society of India (CSI) and Sociedad Latino Americana de Cardiologia Intervencionista (SOLACI). The paper, ““SCAI Expert Consensus Statement: Evaluation, Management, and Special Considerations of Cardio-Oncology Patients in the Cardiac Catherization Laboratory,” is intended to increase the competency of cardiovascular professionals providing care to cancer patients.
“Little data exists as cancer patients have been excluded from national percutaneous coronary interventions (PCI) registries and from most randomized trials involving PCI,” says Cezar A Iliescu, lead author of the document and director of the Cardiac Catheterization Laboratory at MD Anderson Cancer Center in Houston, USA. “Therefore, SCAI commissioned a consensus group to define the landscape and provide recommendations based on the available published medical literature and the expertise of operators with accumulated experience in the cardiac catheterization of cancer patients.”
The document highlights the review of the mechanisms of vascular toxicities in cancer patients (radiation or chemotherapy induced), and covers several other aspects of cardiovascular care such as screening and cardio-protection, as well as PCI in patients with thrombocytopenia and anaemia, fractional flow reserve, intravascular ultrasound and optical coherence tomography for complex intravascular assessment and deferring stenting, if possible. The paper also includes non-coronary interventional procedures in cancer patients like endomyocardial biopsy and pericardiocentesis, as well as aortic valvuloplasty and transcatheter aortic valve implantation.
Cardio-oncology is expected to have continued growth in the coming years. Several healthcare institutions have founded onco-cardiology/cardio-oncology departments, along with fellowship training programs focusing on the cardiology subspecialty.