• Stephane Ederhy, Ariel Cohen, Franck Boccara, Etienne Puymirat, Nadia Aissaoui, Meyer Elbaz, Eric Bonnefoy-Cudraz, Philipe Druelles, Stephane Andrieu, Denis Angoulvant, Alain Furber, Jean Ferrières, François Schiele, Yves Cottin, Tabassome Simon, Nicolas Danchin, and FAST-MI investigators.
• Department of Cardiology, UNICO cardio-oncology program, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; INSERM U 856, 75013 Paris, France.
• Arch Cardiovasc Dis. 2019 Nov 1; 112 (11): 657-669.

BackgroundCancer and acute myocardial infarction (AMI) have important prognostic consequences. Treatment of some cancers may affect coronary artery disease, myocardial function and/or AMI management. Whether the early and long-term mortality of patients with AMI differ according to their history of cancer remains questionable.AimsTo determine in-hospital outcomes and 5-year mortality following AMI according to patient history of cancer.MethodsThe FAST-MI registry is a nationwide French survey collecting data on characteristics, management and outcomes of 3670 consecutive patients admitted for AMI during October 2005.ResultsOverall, 246/3664 patients (6.7%) admitted for an AMI (47.6% with ST-segment elevation myocardial infarction [STEMI]; 52.4% with non-STEMI [NSTEMI]) had a history of cancer. In-hospital mortality was not significantly different for patients with versus without a history of cancer, overall (adjusted odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.68-1.94; P=0.61) and in patients with STEMI (adjusted OR: 1.37, 95% CI: 0.69-2.71; P=0.37) or NSTEMI (adjusted OR: 0.97, 95% CI: 0.41-2.28; P=0.95). All-cause mortality at 5 years was higher among patients with a history of cancer (adjusted hazard ratio [HR]: 1.36, 95% CI: 1.08-1.69; P=0.008), whereas 5-year cardiovascular mortality did not differ (adjusted HR: 1.17, 95% CI: 0.89-1.53; P=0.25), regardless of whether the patients had STEMI or NSTEMI. Similar results were found in populations matched on a propensity score including baseline characteristics and early management.ConclusionA history of cancer, per se, does not appear to be a risk factor for increased in-hospital mortality or long-term cardiovascular mortality in patients admitted for AMI.Copyright © 2019. Published by Elsevier Masson SAS.

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