Affiliation:
1. Department of Medicine Västmanland County Hospital Västerås Sweden
2. Department of Medical Sciences Uppsala University Uppsala Sweden
3. Uppsala Clinical Research Centre Uppsala University Uppsala Sweden
Abstract
Background
Coexistence of cancer and cardiovascular disease is increasingly frequent, but nationwide data covering cancer patients with myocardial infarction (
MI
) are scarce. We sought to investigate the prevalence of cancer in patients with first
MI
, and its impact on cardiovascular and bleeding outcome.
Methods and Results
Using nationwide Swedish quality registries, all patients admitted for first
MI
between 2001 and 2014 were identified. Data on comorbidity, cancer, and outcome were obtained from the national cancer and patient registries. Stratification was performed according to cancer during the 5 years before
MI
. Multivariable Cox proportional hazards analyses adjusting for cardiovascular risk factors and invasive treatment assessed the association of cancer with outcome. In total, 175 146 patients with first
MI
were registered, of whom 9.3% (16 237) had received care for cancer in the 5 years before admission. The cancer rate increased from 6.7% in the years 2001–2002 to 10.7% in 2013–2014, independent of sex and cancer type. The presence of a new cancer diagnosis within 5 years increased from 4.9% to 6.2%. During a median follow‐up of 4.3 years, cancer was associated with all‐cause mortality (hazard ratio, 1.44; 95% CI, 1.40–1.47), recurrent
MI
(hazard ratio, 1.08; 95%
CI
, 1.04–1.12), heart failure (hazard ratio, 1.10; 95%
CI
, 1.06–1.13), and major bleeding (hazard ratio, 1.45; 95%
CI
, 1.34–1.57). Risk for adverse events varied strongly according to cancer extent, timing, and type.
Conclusions
Cancer as a comorbid disorder is increasing and is strongly associated with mortality, severe bleeding, and adverse cardiovascular outcome after first
MI
.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
31 articles.
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