IMPLICATION OF CARDIOVASCULAR PATHOLOGY ON THE RISKS OF THROMBOEMBOLIC COMPLICATIONS IN CANCER PATIENTS

Highlights
It has been demonstrated for the first time that factors such as arterial hypertension, peripheral atherosclerosis, and previous cardiovascular events (heart attack or stroke) significantly increase the risks of both venous and arterial thromboembolic complications in patients with a combination of cardiovascular diseases and malignant neoplasms. The results obtained emphasize the need to review existing scales for assessing the risk of thrombosis in cancer patients and to develop more accurate preventive approaches, including the use of anticoagulant therapy.

Background. Cardiovascular disease (CVD) and cancer are leading causes of mortality worldwide. Although CVD and cancer are generally considered isolated diseases, potential cardiotoxicity has been observed in patients receiving chemotherapy or radiation therapy for cancer treatment. Despite the extensive data in the literature, studies examining the relationship between thromboembolic complications, cancer, and CVD remain limited, necessitating further exploration of this issue.

Aim. To investigate the association between cardiovascular diseases and cancer concerning the risk of developing and progressing thromboembolic complications.

Methods. We retrospectively screened patients with cancer treated between January 1, 2021, and December 31, 2023, at University Clinical Hospital No. 1 of Sechenov University. The study included 877 patients (ages 19 to 93 years, median age 63 years) with histologically confirmed cancer with a high and very high risk of thrombosis (stomach, pancreas, lung, testicles, ovaries, uterus, breast (HER2+ phenotype)).

Results. Our findings indicated that patients with higher stages of the primary tumor (T), regional lymph node metastases (N), and distant metastases (M) had a significantly elevated risk of thrombosis. Additionally, the presence of arterial hypertension (p = 0.01), peripheral atherosclerosis (p = 0.001), history of myocardial infarction and stroke (p = 0.001), and type 2 diabetes mellitus (p = 0.009) were identified as significant risk factors.

Conclusion. This study demonstrates for the first time that arterial hypertension, peripheral atherosclerosis, diabetes mellitus and a history of myocardial infarction and stroke increase the risks of both venous and arterial venous thromboembolism in patients with cancer and cardiovascular disease. According to the results of the regression analysis, the extent of the primary tumor (T) and the presence of peripheral atherosclerosis appeared to be significant factors.

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