Prevalence and outcomes of type 2 myocardial infarction in patients with cancer: A retrospective analysis from the National Inpatient Sample dataset.

Castaldi, Gianluca; Bharadwaj, Aditya S; Bagur, Rodrigo; Van Spall, Harriette G C; Kobo, Ofer; Mamas, Mamas A

Abstract

This study aimed to investigate the prevalence, clinical characteristics and outcomes of type 2 myocardial infarction (T2AMI) in patients with versus without cancer. All hospitalizations with a primary discharge diagnosis of T2AMI were stratified according to cancer status (secondary diagnosis of any-cancer vs cancer-free) using data from the US National Inpatient Sample (2016-2019). The primary outcome was in-hospital all-cause mortality while secondary outcomes were in-hospital major adverse cardiovascular and cerebrovascular events (MACCE). Among 61,305 included hospitalizations with primary diagnosis of T2AMI, 3745 (6.1%) were associated with a diagnosis of cancer. Patients with T2AMI and cancer presented more frequently with acute respiratory failure (23.2% vs 18.1%), acute pulmonary embolism (3.7% v 1.3%), major bleeding (6.8% vs 4.1%) and renal failure (51.0% vs 46.8%), compared to patients without. On adjusted analysis, diagnosis of cancer was associated with lower odds of invasive coronary angiography (aOR 0.75, 95% CI 0.60 to 0.93, p = 0.009) but greater odds of mortality (aOR 1.95, 95% C.I. 1.26-2.99 p = 0.002). Among the different types of cancer, adjusted risk of all-cause mortality was higher in patients with colorectal (aOR 4.17 95% CI 1.68-10.32, p = 0.002), lung (aOR 3.63, 95% CI 1.83-7.18, p < 0.001) and haematologic (aOR 2.48, 95% CI 1.22-5.05, p = 0.001) cancer. Patients with cancer presenting with T2AMI have lower odds of management with invasive diagnostic coronary angiography and have higher rates of in-hospital all-cause death. Further studies are warranted to improve overall care and outcomes of cancer patients and cardiovascular diseases. [Abstract copyright: Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.]

Citation

Castaldi, G., Bharadwaj, A. S., Bagur, R., Van Spall, H. G. C., Kobo, O., & Mamas, M. A. (in press). Prevalence and outcomes of type 2 myocardial infarction in patients with cancer: A retrospective analysis from the National Inpatient Sample dataset. International Journal of Cardiology, 389, Article 131154. https://doi.org/10.1016/j.ijcard.2023.131154

• Journal Article Type: Article
• Acceptance Date: Jul 5, 2023
• Online Publication Date: Jul 11, 2023
• Deposit Date: Aug 1, 2023
• Journal: International journal of cardiology
• Print ISSN: 0167-5273
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 389
• Article Number: 131154
• DOI: https://doi.org/10.1016/j.ijcard.2023.131154
• Keywords: Outcomes, Acute myocardial infarction, Cancer, National Inpatient Sample