Cardio-oncology & otherDiagnostic or prognostic study

Chest Pain in Cancer Patients

JACC CardioOncolPublished

  • Prospective multicentre diagnostic cohort study
  • international multicentre
  • central adjudication
  • external validation cohort

Authors' conclusion

Patients with cancer have a substantially higher prevalence of AMI as the cause of chest pain. Length of ED stay and hospitalization rates are increased. The diagnostic performance of hs-cTnT and the efficacy of both the European Society of Cardiology 0/1-hour hs-cTnT and hs-cTnI algorithms is reduced.

Study context

Population
Patients presenting with chest pain to the emergency department (ED)8,093 eligible for acute myocardial infarction (AMI) analyses
Participants
8,267 patients
Comparison
Cancer vs no cancer
  • Cancern = 711
Outcome
Prevalence of AMI

Performance

As reported in the abstract

Final diagnosis of AMI

P < 0.001

Further findings

Total length of ED stay

P < 0.001

Hospitalization rate

P < 0.001

OutcomeCancerNo cancerP value
Diagnostic accuracy of hs-cTnT for NSTEMIP < 0.001
AUC0.89 (95% CI: 0.86-0.92)0.94 (95% CI: 0.93-0.94)
Diagnostic accuracy of hs-cTnI for NSTEMIP = 0.10
AUC0.93 (95% CI: 0.91-0.95)0.95 (95% CI: 0.94-0.95)

ESC 0/1-hour high-sensitivity cardiac troponin T (hs-cTnT) and high sensitivity cardiac troponin I (hs-cTnI) algorithms in cancer

Very high safety maintained but lower efficacy, with twice the number of patients in the observe zone
Similar findings in the external validation cohort

Original publication

Chest Pain in Cancer Patients. JACC CardioOncol. Published 26 August 2023. doi:10.1016/j.jaccao.2023.08.001

Summarised from the published abstract; every number is checked against it