Abstract 2477
Background
ST-segment myocardial infarction (STEMI) and a history of cancer can coexist because both are highly incident and prevalent. We sought to investigate if a previous diagnosis of cancer influences the outcome of patients with STEMI treated with primary coronary angioplasty.
Methods
We included 917 patients in a prospective cohort observational study, 53 of them (5.8%) cancer survivors. The primary end-point was total mortality.
Results
Out of the 53 patients with history of cancer, all which have been included in the analysis, 12 (23.0%) were treated with chemotherapy, 38 (72.0%) with radiotherapy and 12 (23.0%) had surgical treatment. Cancer locations were: breast cancer in 10 patients (18.9%), gastrointestinal tract in 11 (20.8%), prostate in 10 (18.9%), urologic in 7 (13.2%), hematologic malignancies in 5 (9.4%), respiratory tract in 5 (9.4%) and other locations in 3 (5.7%). One hundred patients died during a median follow-up of 643 days (interquartile range 258 to 1015 days), 88 (10.2%) in patients without cancer and 12 (22.6%) in patients with cancer, being this difference significant (log-rank test=8.4, p = 0.004). Cancer patients were older: 73.4 (11.5) vs 65.2 (13.8) years (p < 0.001), with a lower prevalence of previous stroke: 1.1% vs 2.2%, p = 0.002. The hemoglobin concentration was also lower: 13.4 (2.1) vs 14.4 (1.7) g/L, p = 0.001. No significant differences were found in the data gleaned from the primary angioplasty, although a trend towards a lower use of coronary stents in cancer survivors was noted (p = 0.061). Cancer was associated with a high probability of death, HR = 2.37 (95% confidence interval 1.30 to 4.34), p = 0.005. When confounding variables were included in a multivariate Cox regression model, this association was no longer significant: HR = 1.63 (0.84-3.18), p = 0.150.
Conclusions
We failed to demonstrate a survival advantage of patients with ST-segment myocardial infarction treated with primary coronary angioplasty when patients did not have a previous cancer. The finding of a difference in crude mortality rate can be explained by the baseline differences between both groups.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3140 - Phase 2 study of olaparib in previously treated advanced solid tumors with homologous recombination repair mutation (HRRm) or homologous recombination repair deficiency (HRD): LYNK-002
Presenter: David Hyman
Session: Poster Display session 3
Resources:
Abstract
2655 - The K-BASKET trial: A prospective phase II biomarker-driven multiple basket trial in Korean solid cancer patients.
Presenter: Seul Kim
Session: Poster Display session 3
Resources:
Abstract
5938 - Cambridge Liquid biopsy “CALIBRATION” study: Can changes in circulating tumour DNA (ctDNA) predict durable tumour responses in patients with advanced oesophageal cancer receiving MEDI4736?
Presenter: Constanza Linossi
Session: Poster Display session 3
Resources:
Abstract
3799 - Validation of a tumour mutational burden workflow on routine histological samples of colorectal cancer and assessment of a cohort with synchronous hepatic metastases
Presenter: Andrea Mafficini
Session: Poster Display session 3
Resources:
Abstract
4647 - Microsatellite Instability Testing and Lynch Syndrome Screening For Colorectal Cancer Patients Through Tumor Sequencing
Presenter: Li Liu
Session: Poster Display session 3
Resources:
Abstract
3231 - "Liquid Withdarw" technique in CT-guided cutting needle lung biopsy: decreased incidence of complications and increased tissue amount for lung cancer molecular testing.
Presenter: Xue Wang
Session: Poster Display session 3
Resources:
Abstract
3282 - WGS Implementation in standard cancer Diagnostics for Every cancer patient (WIDE)
Presenter: Paul Roepman
Session: Poster Display session 3
Resources:
Abstract
5905 - Known and unknown gene fusion detection capabilities of solid tumor laboratories conducting next generation sequencing in 6 countries
Presenter: Steph Finucane
Session: Poster Display session 3
Resources:
Abstract
4238 - Clinical and Analytical Accuracy of a 523 Gene Panel Next-Generation Sequencing (NGS) Assay on Formalin-Fixed Paraffin-Embedded (FFPE) Solid Tumor Samples
Presenter: Ina Deras
Session: Poster Display session 3
Resources:
Abstract
2493 - Methylation analysis of MLH1 using droplet digital PCR and methylation sensitive restriction enzyme.
Presenter: Celine De Rop
Session: Poster Display session 3
Resources:
Abstract