Cancer Could Potentially Increase the Risk of Severe Heart Attacks

A prior diagnosis of cancer could potentially increase a patient’s risk of experiencing a severe type of heart attack, findings from a recent study suggest.

In a study published by Mayo Clinic Proceedings, investigators from the Mayo Clinic discovered that this subgroup of patients are 3 times more likely to experience non-cardiac death compared with patients who did not previously have cancer.

Interestingly, patients who have been diagnosed with cancer do not have a higher risk of cardiac-related death, neither at the time of their heart attack nor during the long-term follow-up period.

Included in the study were 2345 patients who experienced a ST-elevation myocardial infarction, a severe acute heart attack commonly known as STEMI. The study examined a 10-year time period, starting in 2010, which was when the current standard stents were first implemented.

Patients were typically followed for an average of 6 years to determine short- and long-term outcomes, according to the study.

“We've watched cancer survivorship increase over the past 2½ decades, which is wonderful, but it has led to new challenges, such as handling of downstream illnesses and side effects to an extent never encountered before,” said senior author Joerg Herrmann, MD. “In particular, as cardiologists, we wanted to know if cancer and its therapies left these patients debilitated from a cardiovascular disease standpoint.”

Investigators also discovered that these patients more frequently visited the hospital for cardiogenic shock, which is an occurrence where the heart does not pump enough blood to the body. Patients with a previous diagnosis of cancer were more likely to receive intra-aortic balloon pump therapy to assist the heart with pumping blood. These findings could potentially mean these patients have a reduced cardiac reserve, according to the study.

Despite arriving at the hospital with worse conditions compared with patients who have not had cancer, the investigators found that patients with a history of cancer do not have a higher risk of cardiovascular-related death.

"This indicates that these patients receive the same, if not greater, benefit from angioplasty for an acute heart attack," Dr Herrmann said.

However, these patients were more likely to die from reasons unrelated to experiencing an acute heart attack, the researchers reported.

Patients who received a cancer diagnosis within 6 months prior to experiencing a heart attack had a 7-fold increased risk of in-hospital death after undergoing an angioplasty, but the researchers said the reason why this happens is unclear. Additional studies will be required to determine the exact causes of this event.

Previously-diagnosed patients had a significantly increased risk of hospitalization due to heart failure during the follow-up period, but there was no increased risk of death from heart disease if the patient received the optimal treatment, according to the study. However, these patients were found to eventually succumb to their cancer.

The discipline known as cardio-oncology is increasing due to growing evidence about the link between cancer diagnosis, treatment, and cardiovascular outcomes.

"This study supports the importance of cardiologists and oncologists working together to care for these patients," Dr Herrmann concluded. "Clearly, our goal is that the cancer patients of today do not become the cardiac patients of the future and, if they do, that we comprehensively see them through."