Outcomes of ST elevation myocardial infarction in patients with cancer: a nationwide study
Authors' conclusion
STEMI patients with cancer have a higher risk of short- and long-term mortality, particularly lung cancer. Colon cancer is the main cancer associated with major bleeding. Cardiovascular disease was the main cause of death in the first month, whereas cancer was the main cause of death within 1 year.
Study context
- Population
- Patients admitted with ST elevation myocardial infarction (STEMI) in the UK, January 2005–March 2019
- Participants
- 353,448 STEMI-indexed admissions
- Exposure
- STEMI with active cancer vs without cancer
- Cancern = 8,581
- Outcome
- Processes of care and clinical outcomes (in-hospital death, bleeding, mortality) according to cancer type
Methodological detailsnational population-based, registry-based (Myocardial Infarction National Audit Project (MINAP), Hospital Episode Statistics)
- National population-based
- Registry-based (MINAP, Hospital Episode Statistics)
Main finding
As reported in the abstract
Cancer vs No cancerEstimate (95% CI)
In-hospital death
OR 1.39(1.25–1.54)
Mortality at 30 days
HR 2.39(2.19–2.62)
Mortality at 1 year
HR 3.73(3.58–3.89)
Observational data: associations, not effects.
Further findings
Invasive coronary revascularization
Mortality, lung cancer
| OR (95% CI) | ||
|---|---|---|
| Lung cancerIn-hospital death | 1.75 (1.39–2.22) | |
| Lung cancerDeath at 1 year | 8.08 (7.44–8.78) | |
| 0.10.31310Odds ratio (log scale) |
- Invasive coronary revascularization: P < 0.001
Mortality, lung cancer
- All common cancer types associated with higher mortality at 1 year
Cause of death
- CV death, main cause in first 30 days
- 62%
- Cancer, main cause of death within 1 year
- 52%
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Bleeding · in-hospitalCancervs No cancer | 1.23 (1.03–1.46) | |
| 0.512Odds ratio (log scale) |
Bleeding · in-hospital
| OR (95% CI) | ||
|---|---|---|
| Colon cancerMajor bleeding | 1.98 (1.24–3.14) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Outcomes of ST elevation myocardial infarction in patients with cancer: a nationwide study. Eur Heart J Qual Care Clin Outcomes. Published 15 March 2023. doi:10.
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