News | Cardio-oncology | September 26, 2017

Treatment of Heart Attack Patients Depends on Cancer History

Cancer patients received less recommended drugs and interventions for myocardial infarction and were more likely to die

Treatment of Heart Attack Patients Depends on Cancer History

September 26, 2017 — Treatment of heart attack patients depends on their history of cancer, according to research published recently in European Heart Journal: Acute Cardiovascular Care.1 The study in more than 35,000 heart attack patients found they were less likely to receive recommended drugs and interventions, and more likely to die in hospital if they had cancer than if they did not.

“It is well known that cancer patients may have an increased risk of cardiovascular disease as a result of their treatment,” said senior author Dragana Radovanovic, M.D., head of the AMIS Plus Data Centre in Zurich, Switzerland. “However, on the other hand, little is known about the treatment and outcomes of cancer patients who have an acute myocardial infarction.”

This study investigated whether acute myocardial infarction patients with a history of cancer received the same guideline recommended treatment and had the same in-hospital outcomes as those without cancer.

The study included 35,249 patients enrolled in the acute myocardial infarction in Switzerland (AMIS Plus) registry between 2002 and mid-2015. Of those, 1,981 (5.6 percent) had a history of cancer.

Propensity score matching was used to create two groups of 1,981 patients each — one with cancer history and one without — that were matched for age, gender and cardiovascular risk factors.

The researchers compared the proportions of patients in each group who received specific immediate drug therapies for acute myocardial infarction, and percutaneous coronary intervention (PCI) to open blocked arteries. They also compared the rates of in-hospital complications and death between the two groups.

The researchers found that cancer patients underwent PCI less frequently (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.67–0.88) and received P2Y12 blockers (OR, 0.82; 95% CI 0.71–0.94) and statins (OR, 0.87; 95% CI, 0.76–0.99) less frequently. In-hospital mortality was significantly higher in patients with cancer than those without (10.7% versus 7.6%; OR, 1.45; 95% CI, 1.17–1.81).

Patients with a history of cancer were more likely to have complications while in hospital. They had 44 percent higher odds of cardiogenic shock, 47 percent higher chance of bleeding, and 67 percent greater odds of developing heart failure than those with no history of cancer.

Radovanovic said: “Patients with a history of cancer were less likely to receive evidence-based treatments for myocardial infarction. They were 24 percent less likely to undergo PCI, 18 percent less likely to receive P2Y12 antagonists and 13 percent less likely to receive statins. They had also more complications and were 45 percent more likely to die while in hospital.”

“More research is needed to find out why cancer patients receive suboptimal treatment for myocardial infarction and have poorer outcomes,” continued Radovanovic.

“Possible reasons could be the type and stage of cancer, or severe comorbidities. Some cancer patients may have a very limited life expectancy and refuse treatment for myocardial infarction,” she added.

For more information: www.journals.sagepub.com

 

References

1. Rohrmann S, Witassek F, Erne P, Rickli H, Radovanovic D. Treatment of patients with myocardial infarction depends on history of cancer. European Heart Journal: Acute Cardiovascular Care. 2017. DOI: 10.1177/2048872617729636

Related Content

MRI May Predict Neurological Outcomes for Cardiac Arrest Survivors
News | Sudden Cardiac Arrest| October 18, 2017
Magnetic resonance imaging (MRI)-based measurements of the functional connections in the brain can help predict long-...
Xarelto Significantly Reduces Major Cardioavascular Events in Stable CAD and PAD Patients
News | Pharmaceuticals| October 18, 2017
October 18, 2017 — Results from the pivotal Phase 3 COMPASS study found that the...
Baylis Medical and Siemens Co-Sponsor Transseptal Access Training Course
News | EP Lab| October 18, 2017
Baylis Medical Co. Inc. and Siemens Healthineers are co-sponsoring a first-of-its kind training program aimed at...
Societies Issue New Performance and Quality Measures for Treating Patients with Heart Attack
News | Cath Lab| October 17, 2017
The American College of Cardiology and the American Heart Association recently released updated clinical performance...
First Patient Enrolled in U.S. Arm of ALIVE Pivotal Heart Failure Trial
News | Heart Failure| October 17, 2017
October 17, 2017 — BioVentrix Inc. recently announced enrollment of the first patient in the U.S.
Dee Dee Wang runs Henry Ford Hospital's 3D printing lab for its complex structural heart cardiology program.

Dee Dee Wang, M.D., runs Henry Ford Hospital's 3-D printing lab that supports its complex structural heart program.

Feature | 3-D Printing| October 13, 2017 | Dave Fornell
Three-dimensional (3-D) printed anatomic models created from a patient’s computed tomography (CT), magnetic resonance...
Low Mortality and Stroke Risks Displayed for Minimally Invasive Aortic Valve Replacements
News | Heart Valve Technology| October 11, 2017
An analysis of more than 1,000 minimally invasive aortic valve replacements and more than 400 additional associated...
New Evaluation Sends Low-Risk ER Chest Pain Patients Home Sooner
News | Cardiac Diagnostics| October 10, 2017
A new evaluation to determine whether emergency room patients with chest pain can go home and follow up with their...
Videos | Chronic Total Occlusion (CTO)| October 09, 2017
Bill Lombardi, M.D., director of complex coronary artery interventions at the University of Washington, discusses the
BTG Acquires Roxwood Medical
News | Business| October 05, 2017
BTG plc announced it has acquired Roxwood Medical, provider of advanced cardiovascular specialty catheters used in the...
Overlay Init