Role of the Platelet Phenomenon in Cardiovascular Diseases and Cancer

About this Research Topic

Background

Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Platelets play a key role in both thrombosis and hemostasis and, according to recent findings, in inflammation, atherogenesis, and cancer metastasis. Platelet indices, i.e. mean platelet volume and platelet count, have been correlated with both vascular and total mortality. The role of platelets in CVD ranges from atherosclerosis development to atherothrombosis and complete occlusion of an arterial vessel. In the conditions recognized as traditional cardiovascular risk factors, platelets circulate in an activated state. Anti-platelet agents are the cornerstone of secondary cardiovascular prophylaxis as well as, of primary cardiovascular prophylaxis in high risk individuals.

Beyond thrombosis and hemostasis, platelets have profound roles in tumor biology, facilitating cancer cell migration and invasiveness thus prompting cancer metastasis. High pre-chemotherapy platelet counts and high levels of soluble P-selectin are now part of risk prediction scores for VTE development, a major cause of morbidity and mortality in cancer. Finally, adult survivors of childhood or adolescent cancer face increased risk of cardiovascular disease, which is the most frequent non-malignant cause of morbidity and mortality in this population. Cardiotoxicity related to chemotherapy and radiotherapy accounts for this increased risk, and anthracycline-based chemotherapy and cardiac radiation are identified as one of the major risk factors in the occurrence of adverse cardiovascular events. However, the magnitude of risk and the manifestations in an individual patient are influenced by numerous other factors including tumor- and host-related factors.

Research is ongoing and further improvements are needed in identifying platelet-related aspects important for better understanding the pathophysiological mechanisms of CVD development and the interaction of CVD and cancer. Finally, progress is necessary in improving the existing prevention strategies for CVD and cancer-related complications in both, active cancer patients and cancer survivors.

Keywords: Platelets, cardiovascular disease, cancer, survivors, antiplatelet therapy.

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