Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:267-73 - Vol. 71 Num.04 DOI: 10.1016/j.rec.2017.07.020

Prevalence and Postdischarge Incidence of Malignancies in Patients With Acute Coronary Syndrome

Alberto Cordero a,b,, Ramón López-Palop a, Pilar Carrillo a, Julio Núñez b,c, Araceli Frutos a, Vicente Bertomeu-González a,b, Fernando Yépez a, Nina Alcantara a, Francisco Ribes a, Mària Juskova a, Vicente Bertomeu-Martínez a

a Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
c Departamento de Cardiología, Hospital Clínico Universitario, Valencia, Spain

Refers to

Keywords

Neoplasms. Acute coronary syndrome. Prognosis.

Abstract

Introduction and objectives

Malignancies are the second cause of death in developed countries after cardiovascular disease and both share common risk factors.

Methods

This prospective study assessed the prevalence and postdischarge incidence of malignancies in all consecutive patients admitted for an acute coronary syndrome.

Results

A total of 1819 patients were included. On admission, the prevalence of malignancies was 3.4%, and 41.9% of the patients were considered disease-free; of the 1731 discharged patients, the incidence was 3.1% (53 cases) and the most common locations were the colon, lung, bladder, and pancreas. Patients with prevalent malignancies were older and had more comorbidities and complications. There were no differences in the revascularization rate, but implantation of drug-eluting stents was less frequent in patients with prevalent malignancies. During follow-up, the median time to diagnosis of incident malignancies was 25 months. On multivariate analysis, independent risk factors were age and current or former smoking. All-cause mortality was much higher in patients with incident (64.2%) or prevalent (40.0%) malignancies. Multivariate analysis showed that prevalent and incident malignancies increased the risk of all-cause mortality by 4-fold.

Conclusions

Among patients admitted for an acute coronary syndrome, 3.8% had a history of malignancy, with less than 50% considered cured. The incidence of new malignancies was 3.4% and both types of malignancies substantially impaired the long-term prognosis.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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