The simultaneous occurrence of cancer and coronary heart disease is increasing in
the Western world. Nevertheless, the influence of cancer on ST elevation myocardial
infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) has
not been investigated extensively. This multicenter registry included patients with
STEMI treated with primary PCI from 2006 to 2009. Patients were stratified according
to history of cancer, and primary focus lay on all-cause and cardiac mortalities during
1-year follow-up. Adjusted effect sizes were calculated using Cox proportional hazard
models. In total, 208 patients had a history of cancer (diagnosed ≤6 months ago in
20.7%, 6 months to 3 years ago in 21.7%, and >3 years ago in 57.6%) and 3,215 patients
had no history of cancer. Chemotherapy had been administered previously to 23% of
patients with cancer. Patients with cancer were older, more frequently women, and
more commonly known with previous myocardial infarction or anemia. Reperfusion rates
were similar after PCI. Patients with cancer showed greater all-cause (17.4% vs 6.5%
in other patients) and cardiac mortalities at 1 year (10.7% vs 5.4% in other patients)
because of high early cardiac death (23.8%) in recently diagnosed patients with cancer.
After adjustment, a recent cancer diagnosis predicted cardiac mortality at 7 days
(hazard ratio 3.34, 95% confidence interval 1.57 to 7.08). The adverse prognosis was
partly explained by anemia and occurrence of cardiogenic shock, whereas outcome was
independent of cancer treatment. In conclusion, patients with cancer showed greater
mortality after STEMI. A cancer diagnosis in the 6 months before primary PCI was strongly
associated with early cardiac mortality.
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Article Info
Publication History
Published online: September 23, 2013
Accepted:
August 6,
2013
Received in revised form:
August 6,
2013
Received:
June 28,
2013
Footnotes
See page 1872 for disclosure information.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
