ASO Author Reflections: Arterial Ischemic Events Following Cancer Surgery: Where Do We Stand?

Abstract

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An elevated risk of arterial ischemic events following non-cardiac surgery has been demonstrated in various studies,^1^ as has the association of elevated troponin levels with 30-day mortality.^2^ Additionally, cancer patients face an augmented risk of cardiovascular complications, likely attributable to treatments associated with their disease.^3^ There is a lack of data on the risk of cardiovascular complications following surgery for different cancers. The aim of this observational cohort study was to improve pre- and postoperative management of cardiovascular complications, tailored for different cancers.

At present, risk assessment is performed routinely based on background comorbidities without taking tumor type into consideration. In this article, we show that different tumor types possess different risk for myocardial infarction or ischemic stroke. Furthermore, we show that in certain tumors, the transient increase of risk is short, up to 1 week after surgery, whereas in some cancers the risk persists over a longer time.^4^

In the future, prospective evaluation of preoperative risk factors is needed to enable selection of patients who need more comprehensive cardiovascular risk assessment before surgery, including intervention. Additionally, it is essential to evaluate the protective effects of antithrombotic medication on outcome incidences.