Prevalence, clinical characteristics, and impact of active cancer in patients with acute myocardial infarction: data from an all-comer registry
| Autor: | Masaru Ishida, Fumiaki Takahashi, Masanobu Niiyama, Kengo Tosaka, Yu Ishikawa, Keiko Tsuji, Yoshihiro Morino, Yudai Shimoda, Tomonori Itoh, Takumi Kimura, Tetsuya Fusazaki, Nozomu Kanehama, Yorihiko Koeda |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Urinary system Myocardial Infarction 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Neoplasms Prevalence Medicine Humans In patient 030212 general & internal medicine Myocardial infarction Registries Aged Retrospective Studies business.industry Incidence (epidemiology) Incidence Cancer Retrospective cohort study medicine.disease Treatment Outcome Cardiology Occult cancer Cardiology and Cardiovascular Medicine business Major bleeding |
| Zdroj: | Journal of cardiology. 78(3) |
| ISSN: | 1876-4738 |
| Popis: | Although a history of cancer is a poor prognostic factor in patients with acute myocardial infarction (AMI), the clinical importance of coexisting active cancer remains unclear.In this single-center retrospective study, we reviewed an AMI registry and assessed the prevalence and predictors of active cancer, 1-year incidence of cardiac death or major bleeding events (defined as a Bleeding Academy Research Consortium type 3 or 5), and the impact of coexisting active cancer on clinical outcomes. Active cancer was defined as either an already-diagnosed or undiagnosed occult cancer.Between January 2012 and December 2017, 1140 AMI patients (median age, 69 years; male, 76.0%) were enrolled. Active and historical cancers were diagnosed in 63 patients (5.5%) and 50 patients (4.4%), respectively. The most common location was the urinary tract (n=21). In the Kaplan-Meier analysis, the active cancer group had a higher incidence of 1-year cardiac death (17.5% vs. 5.3%, p0.001) and major bleeding events (19.0% vs. 5.6%, p0.001) than the non-cancer group. In the multivariate Cox proportional hazards regression models, active cancer was an independent predictor of both cardiac death and major bleeding at 1 year. Specifically, gastrointestinal tract and advanced-stage cancers had the poorest outcomes. Compared to the non-cancer group, the 1-year major bleeding rate was higher for all cancer types and stages. In contrast, early-stage cancers had a weaker impact on the 1-year cardiac mortality compared to advanced-stage cancers. Similarly, cardiac death during 1-year also occurred less frequently in occult cancers than in already-known cancers.In patients with AMI, coexisting active cancer was rare, but it significantly impacted cardiac death and major bleeding events. |
| Databáze: | OpenAIRE |
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