Cardiologists are encountering a growing number of cancer patients with ischaemic heart disease (IHD). Several factors account for the interrelationship between these two conditions, in addition to improving survival rates in the cancer population. Established cardiovascular (CV) risk factors, such as hypercholesterolaemia and obesity, predispose to both IHD and cancer, through specific mechanisms and via low-grade, systemic inflammation. This latter is also fuelled by clonal haematopoiesis of indeterminate potential. Furthermore, experimental work indicates that IHD and cancer can promote one another, and the CV or metabolic toxicity of anticancer therapies can lead to IHD. The connections between IHD and cancer are reinforced by social determinants of health, non-medical factors that modify health outcomes and comprise individual and societal domains, including economic stability, educational and healthcare access and quality, neighbourhood and built environment, and social and community context. Management of IHD in cancer patients is often challenging, due to atypical presentation, increased bleeding and ischaemic risk, and worse outcomes as compared to patients without cancer. The decision to proceed with coronary revascularization and the choice of antithrombotic therapy can be difficult, particularly in patients with chronic coronary syndromes, necessitating multidisciplinary discussion that considers both general guidelines and specific features on a case by case basis. Randomized controlled trial evidence in cancer patients is very limited and there is urgent need for more data to inform clinical practice. Therefore, coexistence of IHD and cancer raises important scientific and practical questions that call for collaborative efforts from the cardio-oncology, cardiology, and oncology communities.

中文翻译：

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癌症患者的缺血性心脏病

心脏病专家遇到越来越多患有缺血性心脏病 (IHD) 的癌症患者。除了提高癌症人群的生存率之外，还有几个因素解释了这两种情况之间的相互关系。已确定的心血管 (CV) 危险因素，例如高胆固醇血症和肥胖，通过特定机制和低度全身炎症，容易诱发 IHD 和癌症。后者也受到不确定潜力的克隆造血作用的推动。此外，实验工作表明 IHD 和癌症可以相互促进，抗癌治疗的 CV 或代谢毒性可导致 IHD。 IHD 与癌症之间的联系因健康的社会决定因素和影响健康结果的非医学因素而得到加强，这些因素包括个人和社会领域，包括经济稳定性、教育和医疗保健的获取和质量、邻里和建筑环境以及社会和社区背景。与非癌症患者相比，癌症患者 IHD 的治疗通常具有挑战性，因为其表现不典型、出血和缺血风险增加以及预后更差。进行冠状动脉血运重建的决定和抗血栓治疗的选择可能很困难，特别是对于患有慢性冠状动脉综合征的患者，需要进行多学科讨论，根据具体情况考虑一般指南和具体特征。癌症患者的随机对照试验证据非常有限，迫切需要更多数据来指导临床实践。因此，IHD 和癌症的共存提出了重要的科学和实际问题，需要心脏肿瘤学、心脏病学和肿瘤学界的共同努力。