Cancer and Acute coronary syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Cardiovascular disease and Cancer are the leading causes of mortality in the world. This is due to the aging of the population and the fact that most of the classic cardiovascular risk factors also predispose to cancer. Cardiovascular disease is the most common cause of late morbidity and mortality among cancer survivors. The incidence of cancer and acute coronary syndrome in the same patient requiring PCI is increasing significantly. The reported prevalence of cancer among patients with acute coronary syndrome ranges between 3% and 17%. In our institution in the past ten months, the prevalence of cancer among patients with ACS who underwent PCI was about 10% (3% in active cancer treatment). Patients with cancer and ACS 41% of patients presented as STEMI, 44% as NSTEMI and 15% as unstable angina. Multivessel coronary disease was confirmed in 36%, Takatsubo was diagnosed in 4%, %=% of patient were treated with percutaneous coronary intervention and stents implantation. They were treated with DAPT; in 39% ticagrelor, 10% prasugrel, others clopidogrel. It was found that lung, prostate, stomach, pancreas and breast cancer are the most common types associated with ACS, which corresponds to our observations. A proinflammatory and hypercoagulable state with increased platelet activation and aggregation commonly occurs in cancer, increasing the prevalence of ACS. New cancer treatments have significantly improved cancer survival, on the other hand, this has at the same time led to an increase in the incidence of CVD. In the general population, NSTEMI is the most common clinical presentation of ACS in cancer patients. MINOCA and Takotsubo syndrome can also occur in cancer patients, more often in women. Percutaneous coronary intervention improves the survival rate of ACS patients, lowering early and late cardiac events. One of the most relevant issues strongly limiting the invasive strategy in cancer patients is the prospect of dual antiplatelet therapy required after PCI. The presence of cancer should not limit the effective and safe treatment of ACS but requires a strict assessment of the risk of bleeding and thrombosis, in both cases with pharmacological and interventional treatment.