Impact of malignancy on clinical outcomes in patients with acute coronary syndromes.

Yousif, Nooraldaem; Niederseer, David; Davies, Allan; El Issa, Meidi; Sidia, Besma; Noor, Husam A; Amin, Haitham; Räber, Lorenz; Gencer, Baris; Klingenberg, Roland; Windecker, Stephan; Mach, François; Matter, Christian M; Nanchen, David; Lüscher, Thomas F; Obeid, Slayman (2021). Impact of malignancy on clinical outcomes in patients with acute coronary syndromes. International journal of cardiology, 328, pp. 8-13. Elsevier 10.1016/j.ijcard.2020.12.010

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BACKGROUND

The impact of cancer on survival in patients with coronary artery disease has not been well defined. We designed the present study to explore the prevalence and prognostic influence of cancer in patients with acute coronary syndrome (ACS).

METHODS

2'132 patients with ACS were enrolled in the prospective, multicenter Special Program University Medicine ACS (SPUM-ACS) cohort. The primary endpoints of major cardiovascular and cerebrovascular events (MACCE) and death were independently adjudicated at 30-day and at one-year follow-up.

RESULTS

Of the 2'132 ACS patients 7.74% (n = 165) had cancer. At 30-day, except for net adverse clinical events (NACE defined as MACCE plus major bleeding), outcomes did not differ significantly between the two groups. At one year, MACCE rate was higher in cancer than in non-cancer patients (21.8 vs. 12.2%, p < 0.001). Even after adjusting for covariates, one-year all-cause mortality was higher in cancer patients than in those without (30.3% vs. 11.9%; p < 0.0001) as was cardiovascular mortality (15.7% vs. 5.9%; p < 0.001) and revascularization (12.7% vs. 5.5%, p < 0.001). Net adverse clinical events were also higher in patients with cancer at one-year follow-up (33.9% vs. 19.8%, p < 0.001). A sub-analysis revealed that those with solid tumors, but not hematological malignancies were more likely to experience MACCE (p = 0.001) as well as a higher cardiovascular and all cause mortality (both p = 0.001) at one-year follow-up.

CONCLUSIONS

ACS patients with cancer, specifically those with solid tumors, have a higher MACCE as well as cardiovascular and total mortality rate than non-cancer patients independent of cardiovascular risk factors. Thus, cancer is an independent risk factor for a poor outcome in ACS patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Räber, Lorenz, Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

20 Jan 2022 16:01

Last Modified:

05 Dec 2022 15:59

Publisher DOI:

10.1016/j.ijcard.2020.12.010

PubMed ID:

33321124

Uncontrolled Keywords:

Acute coronary syndrome Cancer Malignancy Outcomes

BORIS DOI:

10.48350/163231

URI:

https://boris.unibe.ch/id/eprint/163231

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