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Vol. 71. Issue 10.
Pages 880-881 (October 2018)
Vol. 71. Issue 10.
Pages 880-881 (October 2018)
Letter to the Editor
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Cancer and Acute Coronary Syndrome. A Close, but Complicated Relationship. Response
Cáncer y síndrome coronario agudo. Una estrecha, pero complicada relación. Respuesta
Alberto Corderoa,b,
Corresponding author

Corresponding author:
, Vicente Bertomeu-Gonzáleza,b, Julio Núñezb,c, Vicente Bertomeu-Martíneza
a Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
c Departamento de Cardiología, Hospital Clínico Universitario, Valencia, Spain
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Rev Esp Cardiol. 2018;71:879-8010.1016/j.rec.2018.06.025
Gerard Oristrell
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To the Editor,

We appreciate the points raised regarding our study.1 Recent acute coronary syndrome (ACS) constitutes a limitation for some oncological treatments, which could explain the increased noncardiovascular mortality in patients with prevalent or incident malignant tumors. Likewise, we agree that prevalent tumors limit revascularization both quantitively and qualitatively.

However, we would like to qualify the opinion that the results of our study should constitute a starting premise for cardio-oncology units. Cancer affects less than 8% of patients with ACS, which could call into question the efficiency of a having a cardio-oncologist in all care settings. Most patients discharged following ACS receive care at nontertiary hospitals,2 where it is virtually impossible to have specific units for ACS, heart failure, imaging, and cardio-oncology. Rather, we would advocate continuity of care in ACS in such a way that patients receive a personalized follow-up depending on their risk of the more common and serious complications, such as heart failure or reinfarction.3 In fact, we have demonstrated that follow-up in a clinic specific for high-risk ACS is associated with better control of risk factors and improved prognosis.4 Thus, we advocate continuity of care in ACS and personalized follow-up depending on each patient's risk, with rational coordination of those involved in each situation.


A. Cordero received a research grant from the Spanish Society of Cardiology in 2017. A. Cordero and V. Bertomeu-González have received research support from CIBERCV.


A. Cordero, R. López-Palop, P. Carrillo, et al.
Prevalence and Postdischarge Incidence of Malignancies in Patients With Acute Coronary Syndrome.
Rev Esp Cardiol., 71 (2018), pp. 267-273
A. Íñiguez Romo, V. Bertomeu Martínez, L. Rodríguez Padial, et al.
Proyecto RECALCAR. The RECALCAR Project. Healthcare in the Cardiology Units of the Spanish National Health System, 2011 to 2014.
Rev Esp Cardiol, 70 (2017), pp. 567-575
M. Rodríguez-Manero, A. Cordero, O. Kreidieh, et al.
Proposal of a novel clinical score to predict heart failure incidence in long-term survivors of acute coronary syndromes.
Int J Cardiol., 243 (2017), pp. 211-215
A. Cordero, V. Bertomeu González, J. Moreno Arribas, J. Castillo, J. Quiles, V. Bertomeu Martínez.
Prognosis and lipid profile improvement by a specialized outpatient clinic for acute coronary syndrome patients.
Atherosclerosis., 275 (2018), pp. 28-34
Copyright © 2018. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

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