Cancer as a novel Risk Factor for Major Adverse Cardiovascular Events in Secondary Prevention

Abstract

ABSTRACTIntroductionThe inflammatory mechanisms of cancer can be associated with atherosclerosis development and progression. Although there is an incidence rate of cardiovascular events in secondary prevention following a first acute coronary syndrome (ACS).MethodsA retrospective study cohort study including patients who underwent a PCI for first Acute Coronary Syndrome (ACS), and without prior history of Major Cardiovascular Events (MACE) from 2008 to 2022 was analyzed. Included patients were grouped according to the absence or presence of cancer: G1 non-oncologic, and G2 oncologic (either prior or actual history). We compared the incidence rate ratio of MACE within 3 years after STEMI between groups Time-to-event analysis was conducted through proportional Cox regression analysis, estimating hazard ratio, and corresponding 95% confidence intervals (95% CI)ResultsOut of 937 patients who underwent a PCI, 787 patients were included of which 88.7% (n=698) presented without cancer. Over a median follow-up time of 45 months [IQR= 14-72], the incidence rate of MACE was 4.4 cases per 1000 patients/months of follow-up (n=173 MACE events). When comparing both groups, the incidence rate ratio of MACE was 1.9 (95% CI 1.24-2.99), significantly increased in the cancer group (P=0.0032) without showing differences in median follow-up times. Cancer was an independent predictor of MACE HR 1.84 (95% CI 1.19-2.85; P=0.006), adjusted for hypertension, dyslipidemia, diabetes, smoking history, sedentary lifestyle, obesity, age, male gender, and family history of cardiovascular disease.ConclusionsPatients with cancer represent a novel independent risk factor for MACE, even following secondary preventive therapies. These results highlight future endpoints for cardiovascular prevention and further public health interventions on this population.