Andrija Matetic1, Mohamed Mohamed2, Robert J H Miller3, Louis Kolman3, Juan Lopez-Mattei4, Winson Y Cheung5, Darren R Brenner6, Harriette G C Van Spall7, Michelle Graham8, Christopher Bianco9, Mamas A Mamas10. 1. Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK; Department of Cardiology, University Hospital of Split, Split, Croatia. 2. Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK. 3. Department of Cardiac Sciences, University of Calgary, Calgary, Canada. 4. Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Medicine and Oncology, University of Calgary, Calgary, Canada. 6. Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada. 7. Division of Cardiology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada. 8. Division of Cardiology, University of Alberta, Edmonton, Canada. 9. Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA. 10. Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK; Department of Cardiology, Thomas Jefferson University, Philadelphia, USA. Electronic address: mamasmamas1@yahoo.co.uk.
Abstract
INTRODUCTION: There are limited data on causes of cardiovascular (CV) admissions and associated outcomes among patients with different cancers. METHODS: All CV admissions from the US National Inpatient Sample between October 2015 to December 2017 were stratified by cancer type as well as metastatic status. Multivariable logistic regression was performed to determine the adjusted odds ratios (aOR) of in-hospital mortality in different groups. RESULTS: From 5,936,014 eligible CV admissions, cancer was present in 265,221 (4.5%) hospitalizations. There was significant variation in the admission diagnoses among the different cancers, with hematological malignancies being principally associated with heart failure (HF), lung cancer with atrial fibrillation (AF), and colorectal and prostate cancer with acute myocardial infarction (AMI). Admission with haemorrhagic stroke has the highest associated mortality across cancers (20.0-38.4%). In-hospital mortality was higher in cancer than non-cancer patients across most CV admissions (P < 0.001) with AF having the worst prognosis. Compared to group without any cancer, the greatest aOR of mortality was associated with lung cancer in AMI (aOR 2.32, 95% CI 2.18-2.47), ischemic stroke (aOR 2.21, 95%CI 2.08-2.34), AF (aOR 4.69, 95%CI 4.32-5.10) and HF (aOR 2.07, 95%CI 1.89-2.27). CONCLUSIONS: The most common causes of CV admission to hospital vary in patients with different types of cancer, with AMI being most common in patients with colon cancer, HF in patients with hematological malignancies and AF in patients with lung cancer. Patients with cancer, particularly lung cancer, have greater mortality than non-cancer patients after admissions with a CV cause.
INTRODUCTION: There are limited data on causes of cardiovascular (CV) admissions and associated outcomes among patients with different cancers. METHODS: All CV admissions from the US National Inpatient Sample between October 2015 to December 2017 were stratified by cancer type as well as metastatic status. Multivariable logistic regression was performed to determine the adjusted odds ratios (aOR) of in-hospital mortality in different groups. RESULTS: From 5,936,014 eligible CV admissions, cancer was present in 265,221 (4.5%) hospitalizations. There was significant variation in the admission diagnoses among the different cancers, with hematological malignancies being principally associated with heart failure (HF), lung cancer with atrial fibrillation (AF), and colorectal and prostate cancer with acute myocardial infarction (AMI). Admission with haemorrhagic stroke has the highest associated mortality across cancers (20.0-38.4%). In-hospital mortality was higher in cancer than non-cancerpatients across most CV admissions (P < 0.001) with AF having the worst prognosis. Compared to group without any cancer, the greatest aOR of mortality was associated with lung cancer in AMI (aOR 2.32, 95% CI 2.18-2.47), ischemic stroke (aOR 2.21, 95%CI 2.08-2.34), AF (aOR 4.69, 95%CI 4.32-5.10) and HF (aOR 2.07, 95%CI 1.89-2.27). CONCLUSIONS: The most common causes of CV admission to hospital vary in patients with different types of cancer, with AMI being most common in patients with colon cancer, HF in patients with hematological malignancies and AF in patients with lung cancer. Patients with cancer, particularly lung cancer, have greater mortality than non-cancerpatients after admissions with a CV cause.