Impact of Active and Historical Cancer on Short- and Long-Term Outcomes in Patients With Acute Myocardial Infarction

Matsumoto, Tadahiro; Saito, Yuichi; Yamashita, Daichi; Sato, Takanori; Wakabayashi, Shigeo; Kitahara, Hideki; Sano, Koichi; Kobayashi, Yoshio

doi:10.1016/j.amjcard.2021.08.021

Cited by 17 publications

(17 citation statements)

References 28 publications

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“…14 In addition, past treatment with anti-cancer drugs might impair basal organ function of the kidneys, bone marrow, and so on, which could cause non-cardiac complications during AMI treatment. 15 Another notable temporal trend of AMI-NCS observed in the present study was that the prevalence of patients presenting with Killip 1 on admission has increased, whereas that of those with Killip 2 has decreased. This observation was possibly due to the improved emergency transport systems and early diagnosis of AMI (e.g., highsensitivity troponin).…”

Section: Temporal Trends In the Clinical Background Characteristics O...supporting

confidence: 59%

Clinical Characteristics and Outcomes of Patients Presenting With Acute Myocardial Infarction Without Cardiogenic Shock

Okamoto

Nishi

Ishii

et al. 2022

Circ J

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Background: Most patients with acute myocardial infarction (AMI) present in the emergency department in a hemodynamically stable condition (i.e., non-cardiogenic shock) (AMI-NCS). However, few studies specifically focused on the clinical characteristics and outcomes of AMI-NCS patients. Temporal trends in clinical characteristics, in-hospital occurrence of in-hospital adverse outcomes, and the effect of primary percutaneous coronary intervention (PPCI) were examined. Methods and Results:Between April 2012 and March 2018, 176,275 AMI-NCS patients (67.7% of the total AMI population; 25.4% female; mean age 68.6±13.1 years) were identified in a nationwide Japanese administrative database. During the 6-year study period, AMI-NCS patients have been getting older and had an increasing burden of comorbidities. The rates of 30-day all-cause mortality and in-hospital complications were 2.6% and 30.5%, respectively. Thirty-day all-cause mortality did not change significantly over time, whereas in-hospital complications, especially major non-cardiac events, increased progressively. On multivariable analyses, higher age, higher Killip class, atrial fibrillation, chronic renal failure, and malignancy were independently associated with both increased 30-day mortality and in-hospital complications. PPCI was independently associated with lower mortality and in-hospital complications. Conclusions:The clinical background of AMI-NCS patients has been becoming more complex with increasing age and the burden of comorbidities, with increased in-hospital complications. More active and appropriate application of PPCI may further decrease adverse events and improve survival of AMI-NCS patients.

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Section: Temporal Trends In the Clinical Background Characteristics O...supporting

confidence: 59%

Clinical Characteristics and Outcomes of Patients Presenting With Acute Myocardial Infarction Without Cardiogenic Shock

Okamoto

Nishi

Ishii

et al. 2022

Circ J

Self Cite

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“…An analysis of a nationwide sample of US hospitalizations found that in STEMI patients undergoing PCI, 2.1% had a current cancer diagnosis and the rates of adverse events including MACE, all-cause mortality, and major bleeding were significantly higher in the active cancer groups compared to those without cancer [ 19 ]. A Japanese study showed that active cancer was present in 5.4% of patients with AMI undergoing PCI and patients with active cancer had an increased risk of MACE (35% vs.15.1%, p < 0.001) and major bleedings (10% vs. 3.8%, p < 0.001) compared with those with a history of cancer and no cancer during the mean follow-up period of 2.3 years [ 20 ]. Similarly, another Japanese study showed that 5.5% of patients with AMI undergoing PCI had an active cancer and the all-cause death (27.0% vs. 6.0%, p = 0.004) and major bleeding events (19.0% vs. 4.0%, p = 0.016) at 1 year were significantly higher in active cancer group than in the historical cancer group [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Comparisons of drug-eluting balloon versus drug-eluting stent for the treatment of cancer patients presenting with acute myocardial infarction

Yang,

Zhang,

et al. 2023

Eur J Med Res

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Background Treatment for cancer patients presenting with acute myocardial infarction (AMI) remains challenging. The objective of the study was to investigate the safety and efficiency of drug eluting balloon (DEB) versus drug eluting stent (DES) in this high-risk group. Methods Between 1st January 2017 and 1st January 2022, cancer patients admitted to Beijing Chaoyang Hospital with AMI were retrospectively enrolled. The primary endpoint was major adverse cardiovascular event (MACE). The secondary endpoints included major bleeding events, heart failure and cardiac complications. Results A total of 164 cancer patients presenting with AMI were included in the final analysis. Patients treated with DEB had a numerically lower rate of MACE than those treated with DES during a median follow-up of 21.8 months (22.9% vs. 37.1%, p = 0.23). Patients treated with DEB had a trend towards lower rate of major bleeding events than patients treated with DES (6.3% vs. 18.1%, HR 2.96, 95% CI [0.88, 9.92], p = 0.08). There were no significant differences between the two groups with regards to the rate of heart failure (4.2% vs. 9.5%, p = 0.32) and cardiac complications (0.0% vs. 2.6%, p = 0.56). Conclusions The present study demonstrated that in cancer patients with AMI, DEB had a trend towards lower rate of major bleeding events and a numerically lower rate of MACE compared with DES. Graphical Abstract

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“…We conducted a retrospective, bicenter registry study at 2 tertiary referral hospitals, Chiba University Hospital and Eastern Chiba Medical Center [ 13 , 14 , 15 , 16 , 17 , 18 ]. From January 2012 to March 2020, a total of 1102 patients with acute MI including ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) underwent primary PCI.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Factors of In-Hospital Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock

Sato

Saito

Suzuki

et al. 2022

Life

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Among patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS), in-hospital mortality remains high. In the present study, we aimed to identify factors associated with clinical outcomes of acute MI patients with CS in a contemporary setting. A total of 1102 patients with acute MI undergoing primary percutaneous coronary intervention were included, among whom 196 (17.8%) were complicated by CS. The primary outcome was all-cause death during hospitalization, and factors associated with in-hospital mortality were explored in patients with acute MI and CS. Of the 196 patients with acute MI complicated by CS, 77 (39.3%) died during hospitalization. The rates of non-ST-segment elevation MI (NSTEMI) (33.8% vs. 19.3%, p = 0.02) and culprit lesion in the left main or left anterior descending coronary artery (68.8% vs. 47.9%, p = 0.004) were higher, while left ventricular ejection fraction (LVEF) was lower (24.4 ± 11.7% vs. 39.7 ± 13.8%, p < 0.001) in non-survivors than in survivors. Multivariable analysis identified NSTEMI presentation and lower LVEF as independent predictors of in-hospital death. In conclusion, NSTEMI and low LVEF were identified as factors associated with higher in-hospital mortality. The identification of even higher-risk subsets and targeted therapeutic strategies may be warranted to improve survival of patients with acute MI and CS.

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Impact of Active and Historical Cancer on Short- and Long-Term Outcomes in Patients With Acute Myocardial Infarction

Cited by 17 publications

References 28 publications

Clinical Characteristics and Outcomes of Patients Presenting With Acute Myocardial Infarction Without Cardiogenic Shock

Clinical Characteristics and Outcomes of Patients Presenting With Acute Myocardial Infarction Without Cardiogenic Shock

Comparisons of drug-eluting balloon versus drug-eluting stent for the treatment of cancer patients presenting with acute myocardial infarction

Prognostic Factors of In-Hospital Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock

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