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A. Basics
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E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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01. History of Cardiology
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Prognosis of Severe Coronary Disease in Cancer Patients Treated Without Revascularization
Session:
Sessão de Posters 03 - Cardio-oncologia e doença sistémica: onde o cancro encontra o coração
Speaker:
Francisco Salvaterra
Congress:
CPC 2026
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Francisco Salvaterra; Diogo Ferreira; Tiago Rodrigues; Ana Rita Francisco; Cláudia Jorge; Pedro Carrilho; João Marques; José Duarte; J. Marques da Costa; Pedro Cardoso; Miguel Nobre Menezes; Fausto J. Pinto
Abstract
<p><strong>Introduction:</strong><br /> Cancer patients with severe coronary artery disease (CAD) pose important management challenges, particularly when revascularization is not undertaken. Evidence describing the natural history and outcomes of medically managed severe CAD in oncology populations remains limited. This study aims to characterize the clinical profile and long-term outcomes of cancer patients with severe CAD treated exclusively with optimal medical therapy.</p> <p><strong>Methods:</strong><br /> A retrospective cohort study was performed including cancer patients who underwent coronary angiography between 2017 and 2022. Patients with severe CAD managed medically rather than with PCI or CABG were identified. Demographic, cardiovascular, oncologic, laboratory, and angiographic characteristics were extracted from electronic records. Follow-up began at angiography, and predefined outcomes included all-cause and cardiovascular mortality, acute coronary syndromes (ACS), repeat angiography, revascularization, and major bleeding.</p> <p><strong>Results:</strong><br /> Among 318 cancer patients who underwent angiography, 53 had severe CAD managed medically. The cohort was elderly (mean age 77 ± 7), predominantly male, and presented with a substantial burden of cardiovascular comorbidities. Genitourinary (44%) and gastrointestinal (24%) cancers were most frequent. Functional status was generally preserved, with 70% ECOG 0–1, while 24% had stage IV disease. Nearly half (45%) underwent angiography for ACS. Cardiovascular risk factors were prevalent: hypertension (93%), diabetes (40%), dyslipidemia (68%), smoking history (51%), prior MI (26%), prior PCI (26%), and chronic kidney disease (51%).<br /> Severe multivessel CAD was common, involving the LAD (54%), circumflex (58%), and RCA (61%). Despite angiographic severity, ischemic complications were infrequent: 4 patients (7.5%) developed ACS, 6 (11.3%) required repeat angiography, and 2 (3.8%) underwent revascularization. Major bleeding occurred in two patients.<br /> Overall mortality reached 63%. Among the 35 deaths with a documented cause, non-cardiovascular mortality predominated (74%), whereas cardiovascular causes accounted for 26%, indicating outcomes were largely driven by cancer-related or other non-cardiac conditions rather than CAD progression.</p> <p><strong>Conclusion:</strong><br /> In cancer patients with severe CAD managed conservatively, long-term survival is poor and primarily shaped by non-cardiovascular mortality. Recurrent ischemia, repeat angiography, and revascularization were uncommon, suggesting that in selected oncology patients a conservative strategy may be appropriate, as prognosis depends mainly on the underlying malignancy.</p>
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