Top Things to Know: Coronary Atherosclerosis in Patients with Cancer & Survivors
Published: February 09, 2026
Prepared by Paul St. Laurent, DNP, RN, Vice President, Science & Medicine American Heart Association
- Cancer and atherosclerotic cardiovascular disease (ASCVD) share common risk factors such as inflammation, aging, and lifestyle behaviors, and cancer treatments can accelerate the development of atherosclerosis.
- Cancer treatments such as chemotherapy, targeted agents, immunotherapy, and radiation can promote coronary artery disease through endothelial injury, inflammation, and pro-thrombotic effects.
- Cardiovascular (CV) risk assessment should begin at the time of cancer diagnosis, with early involvement of cardiology and baseline imaging to guide preventive strategies.
- Non-invasive imaging techniques such as cardiac CT, PET, cardiac MRI, and echocardiography are essential for detecting subclinical ASCVD and tailoring treatment in patients with cancer.
- Surveillance guidelines recommend periodic imaging, including coronary artery calcium scoring and stress testing, especially 5–10 years after radiation therapy or in high-risk but asymptomatic patients.
- Percutaneous coronary intervention (PCI) is safe and effective in patients with cancer but requires individualized planning due to elevated bleeding and thrombotic risks.
- Lifestyle modifications and adherence to guideline-directed medical therapy, including statins and antihypertensives, are essential yet underused strategies for ASCVD prevention in cancer survivors.
- Artificial intelligence is transforming cardiovascular imaging by enabling rapid and reproducible coronary plaque quantification to improve risk prediction and care planning.
- Key research gaps remain, including limited data on therapy-related ASCVD risk across diverse populations, and the efficacy of preventative medication.
- Effective ASCVD management in cancer patients requires a multidisciplinary team—oncology, cardiology, and imaging—to ensure coordinated, personalized care.
Citation
Zhang L, Iliescu C, Ferencik M, Finamore V, Beavers C, Patel AR, Ghoshhajra B, Milgrom S, Dent S, Baldassarre LA, Jaffe IZ, Lopez-Mattei J; on behalf of the American Heart Association Cardio-Oncology Committee of the Council on Clinical Cardiology and Council on Genomic and Precision Medicine; Council on Cardiovascular and Stroke Nursing; and Council on Lifestyle and Cardiometabolic Health. Coronary atherosclerosis in patients with cancer and survivors: a scientific statement from the American Heart Association. Circulation. Published online February 9, 2026. doi: 10.1161/CIR.0000000000001391