Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction
Background: Patients with cancer are at increased risk of acute myocardial infarction (AMI). It is unclear if the Atherosclerotic Cardiovascular Disease (ASCVD) risk score at incident AMI is reflective of this higher risk in patients with prior cancer than those without. Methods: We linked nationwid...
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MDPI AG
2022-10-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/10/11/2681 |
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| author | Chieh Yang Koo Huili Zheng Li Ling Tan Ling-Li Foo Derek J. Hausenloy Wee-Joo Chng Soo Chin Lee Arthur Mark Richards Lieng-Hsi Ling Shir Lynn Lim Chi-Hang Lee Mark Y. Chan |
| author_facet | Chieh Yang Koo Huili Zheng Li Ling Tan Ling-Li Foo Derek J. Hausenloy Wee-Joo Chng Soo Chin Lee Arthur Mark Richards Lieng-Hsi Ling Shir Lynn Lim Chi-Hang Lee Mark Y. Chan |
| author_sort | Chieh Yang Koo |
| collection | DOAJ |
| description | Background: Patients with cancer are at increased risk of acute myocardial infarction (AMI). It is unclear if the Atherosclerotic Cardiovascular Disease (ASCVD) risk score at incident AMI is reflective of this higher risk in patients with prior cancer than those without. Methods: We linked nationwide AMI and cancer registries from 2008 to 2019. A total of 18,200 eligible patients with ASCVD risk score calculated at incident AMI were identified (1086 prior cancer; 17,114 no cancer). Results: At incident AMI, age-standardized mean ASCVD risk was lower in the prior cancer group (18.6%) than no cancer group (20.9%) (<i>p</i> < 0.001). Prior to incident AMI, smoking, hypertension, hyperlipidemia and diabetes mellitus were better controlled in the prior cancer group. However post-AMI, prior cancer was associated with lower guideline-directed medical therapy usage and higher all-cause mortality (adjusted hazard ratio 1.85, 95% confidence interval 1.66–2.07). Conclusions: AMI occurred despite better control of cardiovascular risk factors and lower age-standardized estimated mean 10-year ASCVD risk among patients with prior cancer than no cancer. Prior cancer was associated with lower guideline-directed medical therapy post-AMI and higher mortality. |
| first_indexed | 2024-03-09T19:14:47Z |
| format | Article |
| id | doaj.art-01c16bc4161a4b13a543c5a6585ba87b |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T19:14:47Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-01c16bc4161a4b13a543c5a6585ba87b2023-11-24T03:48:59ZengMDPI AGBiomedicines2227-90592022-10-011011268110.3390/biomedicines10112681Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial InfarctionChieh Yang Koo0Huili Zheng1Li Ling Tan2Ling-Li Foo3Derek J. Hausenloy4Wee-Joo Chng5Soo Chin Lee6Arthur Mark Richards7Lieng-Hsi Ling8Shir Lynn Lim9Chi-Hang Lee10Mark Y. Chan11Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeNational Registry of Diseases Office, Health Promotion Board, Singapore 168937, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeNational Registry of Diseases Office, Health Promotion Board, Singapore 168937, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeBackground: Patients with cancer are at increased risk of acute myocardial infarction (AMI). It is unclear if the Atherosclerotic Cardiovascular Disease (ASCVD) risk score at incident AMI is reflective of this higher risk in patients with prior cancer than those without. Methods: We linked nationwide AMI and cancer registries from 2008 to 2019. A total of 18,200 eligible patients with ASCVD risk score calculated at incident AMI were identified (1086 prior cancer; 17,114 no cancer). Results: At incident AMI, age-standardized mean ASCVD risk was lower in the prior cancer group (18.6%) than no cancer group (20.9%) (<i>p</i> < 0.001). Prior to incident AMI, smoking, hypertension, hyperlipidemia and diabetes mellitus were better controlled in the prior cancer group. However post-AMI, prior cancer was associated with lower guideline-directed medical therapy usage and higher all-cause mortality (adjusted hazard ratio 1.85, 95% confidence interval 1.66–2.07). Conclusions: AMI occurred despite better control of cardiovascular risk factors and lower age-standardized estimated mean 10-year ASCVD risk among patients with prior cancer than no cancer. Prior cancer was associated with lower guideline-directed medical therapy post-AMI and higher mortality.https://www.mdpi.com/2227-9059/10/11/2681cardio-oncologycoronary artery diseasepreventive cardiologycancer survivorshiprisk factors |
| spellingShingle | Chieh Yang Koo Huili Zheng Li Ling Tan Ling-Li Foo Derek J. Hausenloy Wee-Joo Chng Soo Chin Lee Arthur Mark Richards Lieng-Hsi Ling Shir Lynn Lim Chi-Hang Lee Mark Y. Chan Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction Biomedicines cardio-oncology coronary artery disease preventive cardiology cancer survivorship risk factors |
| title | Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction |
| title_full | Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction |
| title_fullStr | Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction |
| title_full_unstemmed | Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction |
| title_short | Prior Cancer Is Associated with Lower Atherosclerotic Cardiovascular Disease Risk at First Acute Myocardial Infarction |
| title_sort | prior cancer is associated with lower atherosclerotic cardiovascular disease risk at first acute myocardial infarction |
| topic | cardio-oncology coronary artery disease preventive cardiology cancer survivorship risk factors |
| url | https://www.mdpi.com/2227-9059/10/11/2681 |
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