Arterial and Venous Thrombosis in Cancer Patients英文文献资料.docVIP

SAGE-HindawiAccesstoResearch CardiologyResearchandPractice Volume2011,ArticleID394740,11pages doi:10.4061/2011/394740 ReviewArticle ArterialandVenousThrombosisinCancerPatients AndrewD.Blann andSimonDunmore 1 2 1 2 UniversityofBirminghamCentreforCardiovascularSciences,DepartmentofMedicine,CityHospital,BirminghamB187QH,UK DepartmentofBiomedicalSciencePhysiology,SchoolofAppliedSciences,ResearchInstituteinHealthcareSciences, UniversityofWolverhampton,WulfrunaStreet,WolverhamptonWV11AD,UK CorrespondenceshouldbeaddressedtoAndrewD.Blann,a.blann@bham.ac.uk Received22October2010;Accepted4January2011 AcademicEditor:SyedWamiqueYusuf Copyright?2011A.D.BlannandS.Dunmore. This is an open access article distributed under the Creative Commons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arisingfromfailureofthecoronarymacro-andmicrocirculationtodeliverenoughoxygenatedredcellstothecardiomyocytes. Theprinciplereasonforthisisocclusivethrombosis,eitherbyisolatedcirculatingthrombi,orbyruptureofupstreamplaque. However,anadditionallyseriouspathologycausingpotentiallyfatalstresstotheheartisextra-cardiacdisease,suchaspulmonary hypertension. Aprimary causeofthelatterispulmonary embolus,consideredto be avenousthromboembolism.Whilstthe thromboticscenariohasfordecadesbeenthedominatingparadigmincardiovasculardisease,theseissueshave,untilrecently, beeninfrequentlyconsideredincancer.However,thereisnowadevelopingviewthatcancerisalsoathromboticdisease,and notablyadiseasepredominantlyofthevenouscirculation,manifestingasdeepveinthrombosisandpulmonaryembolism.Indeed, formany,avenousthromboembolismisoneofthe?rstsymptomsofadevelopingcancer.Furthermore,manyofthestandard chemotherapiesincancerareprothrombotic.Accordingly,thromboprophylaxisincancerwithheparinsororalanticoagul