Previously diagnosed cancer and mortality after ST-segment elevation acute myocardial infarction treated with primary angioplasty.
Catheter Cardiovasc Interv
; 95(7): 1269-1274, 2020 06 01.
Article
en En
| MEDLINE
| ID: mdl-31584247
ABSTRACT
OBJECTIVE:
We investigated if a previous cancer diagnosis influences the outcome of patients with STEMI treated with primary coronary intervention (PCI).BACKGROUND:
ST-segment myocardial infarction (STEMI) and a history of cancer can coexist because both have a high incidence and prevalence.METHODS:
Prospective cohort observational study, The primary end-point was total mortality.RESULTS:
We included 917 patients, 53 of them (5.8%) were cancer survivors. During follow-up (median, 643 days [interquartile range, 258 to 1,015 days]), 100 patients died, 88 (10.2%) patients without a cancer diagnosis and 12 (22.6%) patients with a previous cancer diagnosis, which was significantly different (log-rank test = 8.4, p = .004). Cancer patients were older (73.4 (11.5) vs. 65.2 (13.8) years, p < .001), with a lower prevalence of previous stroke (1.1% vs. 2.2%, p = .002). Their hemoglobin concentration was also lower (13.4 (2.1) vs. 14.4 (1.7) g/L, p = .001). A trend towards a lower use of coronary stents in cancer survivors was noted (p = .061). Cancer was associated with a high probability of death (HR = 2.37, 95% confidence interval [CI] 1.30-4.34, p = .005). When confounding variables were included, this association was no longer significant (HR = 1.63, 95% CI 0.84-3.18, p = .150).CONCLUSIONS:
Patients with a previous cancer diagnosis who had an acute STEMI treated by primary PCI did not seem to have a worse prognosis. The difference in the crude mortality rate can be explained by the baseline differences between both groups. Previous cancer diagnosis should not be included in the clinical decision process when a patient is having an acute STEMI.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Intervención Coronaria Percutánea
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Infarto del Miocardio con Elevación del ST
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Supervivientes de Cáncer
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Neoplasias
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Asunto de la revista:
CARDIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
España