Stephane Ederhy1, Ariel Cohen1, Franck Boccara2, Etienne Puymirat3, Nadia Aissaoui4, Meyer Elbaz5, Eric Bonnefoy-Cudraz6, Philipe Druelles7, Stephane Andrieu8, Denis Angoulvant9, Alain Furber10, Jean Ferrières11, François Schiele12, Yves Cottin13, Tabassome Simon14, Nicolas Danchin15. 1. Department of Cardiology, UNICO cardio-oncology program, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; INSERM U 856, 75013 Paris, France. 2. Department of Cardiology, UNICO cardio-oncology program, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; INSERM, UMR-S 938, UPMC, 75571 Paris, France. 3. Department of Cardiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; INSERM U 970, 75015 Paris, France. 4. Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Department of Critical Care Unit, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France. 5. Department of Cardiology, Toulouse University Hospital, 31300 Toulouse, France. 6. Hôpital Cardiologique Louis-Pradel, 69500 Bron, France; Université Lyon 1, 69622 Lyon, France. 7. Service de Cardiologie, Clinique Saint-Laurent, 35700 Rennes, France. 8. Service de Cardiologie, Centre Hospitalier d'Avignon, 84000 Avignon, France. 9. Centre Hospitalier Universitaire Trousseau, 37170 Chambray-lès-Tours, France; Faculté de Médecine, Université François-Rabelais, 37032 Tours, France. 10. Laboratoire Cardioprotection, Remodelage et Thrombose, Institut MitoVasc, University of Angers, 49100 Angers, France; Department of Cardiology, University Hospital of Angers, 49100 Angers, France. 11. Service de Cardiologie, Department of Cardiology B and Epidemiology, Toulouse University Hospital, 31300 Toulouse, France; UMR INSERM 1027, 31000 Toulouse, France. 12. Hôpital Jean-Minjoz, 25000 Besançon, France; Université de Franche Comté, 25030 Besançon, France. 13. Hôpital du Bocage, 21000 Dijon, France; Université de Bourgogne, 21078 Dijon, France. 14. Unité de Recherche Clinique (URC-EST), Hôpital Saint-Antoine, AP-HP, 75911 Paris, France; INSERM U698, 75877 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France. 15. Department of Cardiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; INSERM U 970, 75015 Paris, France. Electronic address: nicolasdanchin@yahoo.fr.
Abstract
BACKGROUND: Cancer and acute myocardial infarction (AMI) have important prognostic consequences. Treatment of some cancers may affect coronary artery disease, myocardial function and/or AMI management. Whether the early and long-term mortality of patients with AMI differ according to their history of cancer remains questionable. AIMS: To determine in-hospital outcomes and 5-year mortality following AMI according to patient history of cancer. METHODS: The FAST-MI registry is a nationwide French survey collecting data on characteristics, management and outcomes of 3670 consecutive patients admitted for AMI during October 2005. RESULTS: Overall, 246/3664 patients (6.7%) admitted for an AMI (47.6% with ST-segment elevation myocardial infarction [STEMI]; 52.4% with non-STEMI [NSTEMI]) had a history of cancer. In-hospital mortality was not significantly different for patients with versus without a history of cancer, overall (adjusted odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.68-1.94; P=0.61) and in patients with STEMI (adjusted OR: 1.37, 95% CI: 0.69-2.71; P=0.37) or NSTEMI (adjusted OR: 0.97, 95% CI: 0.41-2.28; P=0.95). All-cause mortality at 5 years was higher among patients with a history of cancer (adjusted hazard ratio [HR]: 1.36, 95% CI: 1.08-1.69; P=0.008), whereas 5-year cardiovascular mortality did not differ (adjusted HR: 1.17, 95% CI: 0.89-1.53; P=0.25), regardless of whether the patients had STEMI or NSTEMI. Similar results were found in populations matched on a propensity score including baseline characteristics and early management. CONCLUSION: A history of cancer, per se, does not appear to be a risk factor for increased in-hospital mortality or long-term cardiovascular mortality in patients admitted for AMI.
BACKGROUND:Cancer and acute myocardial infarction (AMI) have important prognostic consequences. Treatment of some cancers may affect coronary artery disease, myocardial function and/or AMI management. Whether the early and long-term mortality of patients with AMI differ according to their history of cancer remains questionable. AIMS: To determine in-hospital outcomes and 5-year mortality following AMI according to patient history of cancer. METHODS: The FAST-MI registry is a nationwide French survey collecting data on characteristics, management and outcomes of 3670 consecutive patients admitted for AMI during October 2005. RESULTS: Overall, 246/3664 patients (6.7%) admitted for an AMI (47.6% with ST-segment elevation myocardial infarction [STEMI]; 52.4% with non-STEMI [NSTEMI]) had a history of cancer. In-hospital mortality was not significantly different for patients with versus without a history of cancer, overall (adjusted odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.68-1.94; P=0.61) and in patients with STEMI (adjusted OR: 1.37, 95% CI: 0.69-2.71; P=0.37) or NSTEMI (adjusted OR: 0.97, 95% CI: 0.41-2.28; P=0.95). All-cause mortality at 5 years was higher among patients with a history of cancer (adjusted hazard ratio [HR]: 1.36, 95% CI: 1.08-1.69; P=0.008), whereas 5-year cardiovascular mortality did not differ (adjusted HR: 1.17, 95% CI: 0.89-1.53; P=0.25), regardless of whether the patients had STEMI or NSTEMI. Similar results were found in populations matched on a propensity score including baseline characteristics and early management. CONCLUSION: A history of cancer, per se, does not appear to be a risk factor for increased in-hospital mortality or long-term cardiovascular mortality in patients admitted for AMI.