Cancer Diagnosis May Affect Heart Attack Treatment

A new study published by the European Heart Journal: Acute Cardiovascular Care indicates that patients with cancer may receive care for heart attacks that strays from current guidelines. The authors found that patients were less likely to receive the recommended treatments and interventions if they were diagnosed with cancer.

Patients with cancer who experienced a heart attack were also more likely to die in the hospital compared with patients without cancer, according to the study.

“It is well known that cancer patients may have an increased risk of cardiovascular disease as a result of their treatment,” said senior author Dragana Radovanovic, MD. “However, on the other hand, little is known about the treatment and outcomes of cancer patients who have an acute myocardial infarction.”

The authors explored whether patients with a history of cancer who experienced an acute myocardial infarction received the same treatment and had the same outcomes as patients without cancer.

Included in the study were 35,249 patients who experienced an acute myocardial infarction between 2002 and 2015. Of these patients, 5.6% had cancer. Patients were grouped by cancer status and matched for age, gender, and cardiovascular factors.

The authors examined the number of patients who received specific drug therapies and percutaneous coronary intervention (PCI), while also comparing the rate of in-hospital complications and deaths.

The authors discovered that patients with cancer underwent PCI less frequently and were less likely to receive therapy with P2Y12 blockers and statins, according to the study. Additionally, 10.7% of patients with cancer died in the hospital, while only 7.6% of patients without cancer died in the hospital.

“Patients with a history of cancer were less likely to receive evidence-based treatments for myocardial infarction. They were 24% less likely to undergo PCI, 18% less likely to receive P2Y12 antagonists and 13% less likely to receive statins,” Dr Radovanovic said. “They had also more complications and were 45% more likely to die while in hospital.”

Patients with cancer were also found to have higher incidence of complications in the hospital, including a 44% increased risk of cardiogenic shock, 47% increased risk of bleeding, and a 67% increased risk of developing heart failure compared with patients without cancer, according to the study.

Additional studies are needed to confirm these findings, but the authors hypothesize that factors related to cancer may influence heart attack treatment.

“More research is needed to find out why cancer patients receive suboptimal treatment for myocardial infarction and have poorer outcomes,” Dr Radovanovic concluded. “Possible reasons could be the type and stage of cancer, or severe comorbidities. Some cancer patients may have a very limited life expectancy and refuse treatment for myocardial infarction.”