Impact of a Cancer History on Cardiovascular Events Among Patients With Myocardial Infarction Who Received Revascularization

Abstract

Background: It remains controversial whether a cancer history increases the risk of cardiovascular (CV) events among patients with myocardial infarction (MI) who undergo revascularization. Methods and Results:Patients who were confirmed as type 1 acute MI (AMI) by coronary angiography were retrospectively analyzed. Patients who died in hospital or those not undergoing revascularization were excluded. Patients with a cancer history were compared with those without it. A cancer history was examined in the in-hospital cancer registry. The primary outcome was a composite of cardiac death, recurrent type 1 MI, post-discharge coronary revascularization, heart failure hospitalization, and stroke. Among 551 AMI patients, 55 had a cancer history (cancer group) and 496 did not (non-cancer group). Cox proportional hazards model revealed that the risk of composite endpoint was significantly higher in the cancer group than in the non-cancer group (adjusted hazard ratio [HR]: 1.78; 95% confidence interval [CI]: 1.13-2.82). Among the cancer group, patients who were diagnosed as AMI within 6 months after the cancer diagnosis had a higher risk of the composite endpoint than those who were diagnosed as AMI 6 months or later after the cancer diagnosis (adjusted HR: 5.43; 95% CI: 1.55-19.07). Conclusions:A cancer history increased the risk of CV events after discharge among AMI patients after revascularization.

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“…El equilibrio entre trombosis y hemorragia es más complejo en pacientes con cáncer. Los pacientes con cáncer activo o antecedente de cáncer representan aproximadamente el 10% de los SCA (198,199). A pesar de su elevada prevalencia, son excluidos habitualmente de los estudios aleatorizados para el manejo de los SCA, limitando la calidad y cantidad de evidencia científica relacionada con este tópico.…”