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
5760 - Landscape of PD-L1 expression status in Chinese solid tumor patients.
Presenter: Yi Zhong
Session: Poster Display session 3
Resources:
Abstract
3733 - Anti-cancer and immunomodulatory effects of cobimetinib in triple negative breast cancer
Presenter: Chun-Yu Liu
Session: Poster Display session 3
Resources:
Abstract
4426 - Differential expression of immunoregulatory molecules and highly-associated cancer genes may provide novel insights into strategic trial design for therapeutics
Presenter: Jacob Adashek
Session: Poster Display session 3
Resources:
Abstract
2752 - Insights into the Tumor Immune Microenvironment using Tissue Phenomics to Drive Cancer Immunotherapy
Presenter: Martin Groher
Session: Poster Display session 3
Resources:
Abstract
5713 - Immune competent somatic mosaic model of colorectal cancer
Presenter: Stefania Napolitano
Session: Poster Display session 3
Resources:
Abstract
1898 - Genomic correlates of response to anti-PDL1 Atezolizumab in non-small-cell lung cancer OAK and POPLAR trials
Presenter: Hari Singhal
Session: Poster Display session 3
Resources:
Abstract
3246 - Erdafitinib (erda) versus available therapies in advanced urothelial cancer: A matching adjusted indirect comparison
Presenter: Yohann Loriot
Session: Poster Display session 3
Resources:
Abstract
3311 - High level of activity of Nivolumab anti-PD-1 immunotherapy and favorable outcome in metastatic/refractory MSI-H non-colorectal cancer: Results of the MSI cohort from the French AcSé program
Presenter: Christophe Tournigand
Session: Poster Display session 3
Resources:
Abstract
2314 - TP53 and ATM Co-mutation Predicts Response to Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer
Presenter: Yu Chen
Session: Poster Display session 3
Resources:
Abstract
4692 - Immune cell biomarkers on neo-adjuvant chemo-immunotherapy treatment for resectable stage IIIA NSCLC patients
Presenter: Raquel Laza-Briviesca
Session: Poster Display session 3
Resources:
Abstract