Skip to main content

Advertisement

SpringerLink
Log in

Risk of mortality and other adverse outcomes from myocardial infarction in cancer survivors: a meta-analysis

  • Review Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background and purpose

Myocardial infarction (MI) is an acute cardiovascular disease that can increase prognosis risks such as arrhythmia, heart failure, shock, etc. Studies have found that even well-controlled coexistence of cancer could affect the quality of life in MI patients. However, the prognostic impact of cancer on MI patients is controversial. This meta-analysis aimed to assess the influence of cancer on the risk of future all-cause mortality, cardiovascular mortality, and major adverse cardiovascular and cerebrovascular events (MACCE) in MI patients.

Methods

The Embase, PubMed, and Cochrane libraries were searched for cohort studies and case–control from inception to May 2022. The quality of the included pieces of literature was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). All statistical analyses were performed using Stata statistical software versions 14.0 and 16.0. Sensitivity analysis assessed the robustness of the results, and funnel plots and Egger’s tests evaluated the publication bias.

Results

A total of 10 studies were included, covering 7,210,530 participants. Summary analyses show that compared with non-cancer patients, cancer increased the risk of long-term all-cause mortality in MI patients (HR 1.58, 95% CI 1.36–1.84, I2 = 94.2%). However, no significant difference was observed in the risk of cardiovascular mortality (HR 1.18, 95% CI 0.91–1.54, I2 = 52.4%) or MACCE (HR 1.26, 95% CI 0.94–1.70, I2 = 99.2%). In subgroup analysis, cancer was associated with the risk of recurrent MI (HR 1.18, 95% CI 1.03–1.34, I2 = 88.8%), and major bleeding (HR 2.01, 95% CI 1.60–2.52, I2 = 93.1%), with no significant difference in the risk of stroke (HR 1.11, 95% CI 0.97–1.27, I2 = 85.1%).

Conclusion

This meta-analysis shows that cancer increases the risk of all-cause mortality, recurrent MI, and major bleeding in MI patients but is not associated with the risk of cardiovascular death. Therefore, comprehensive multidisciplinary management and monitoring of potential future adverse events in MI patients with cancer are needed.

Systematic review registration

The meta-analysis was registered in the International Register of Prospective Systematic Reviews (NO. CRD42022332775).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig.2
Fig.3

Similar content being viewed by others

Data availability

The original datasets presented can be found in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.

References

  1. Seton-Rogers S (2020) Cardiovascular disease and cancer communicate. Nat Rev Cancer 20:552. https://doi.org/10.1038/s41568-020-0294-6

    Article  CAS  Google Scholar 

  2. Moslehi J (2013) The cardiovascular perils of cancer survivorship. N Engl J Med 368:1055–1056. https://doi.org/10.1056/NEJMe1215300

    Article  CAS  Google Scholar 

  3. Kwon HK, Han KD, Cheon YI et al (2021) The incidence of myocardial infarction and stroke in head and neck cancer patients. Sci Rep 11:4174. https://doi.org/10.1038/s41598-021-83665-4

    Article  CAS  Google Scholar 

  4. Koo CY, Zheng H, Tan LL et al (2021) Lipid profiles and outcomes of patients with prior cancer and subsequent myocardial infarction or stroke. Sci Rep 11:21167. https://doi.org/10.1038/s41598-021-00666-z

    Article  Google Scholar 

  5. Li N, Huang Z, Zhang Y et al (2019) Increased cancer risk after myocardial infarction: fact or fiction? A systemic review and meta-analysis. Cancer Manag Res 11:1959–1968. https://doi.org/10.2147/CMAR.S193658

    Article  Google Scholar 

  6. Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249. https://doi.org/10.3322/caac.21660

    Article  Google Scholar 

  7. Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

    Article  Google Scholar 

  8. Taylor KS, Mahtani KR, Aronson JK (2021) Summarising good practice guidelines for data extraction for systematic reviews and meta-analysis. BMJ Evid Based Med 26:88–90. https://doi.org/10.1136/bmjebm-2020-111651

    Article  Google Scholar 

  9. Peng X, Wang Z, Cao M et al (2022) A concomitant cancer diagnosis is associated with poor cardiovascular outcomes among acute myocardial infarction patients. Front Cardiovasc Med 9:758324. https://doi.org/10.3389/fcvm.2022.758324

    Article  CAS  Google Scholar 

  10. Tosaka K, Ishida M, Tsuji K et al (2021) Prevalence, clinical characteristics, and impact of active cancer in patients with acute myocardial infarction: data from an all-comer registry. J Cardiol 78:193–200. https://doi.org/10.1016/j.jjcc.2021.04.004

    Article  Google Scholar 

  11. Zheng R, Kusunose K, Okushi Y et al (2021) Impact of cancer on short-term in-hospital mortality after primary acute myocardial infarction. Open Heart 8:e001860. https://doi.org/10.1136/openhrt-2021-001860

    Article  Google Scholar 

  12. Bharadwaj A, Potts J, Mohamed MO et al (2020) Acute myocardial infarction treatments and outcomes in 6.5 million patients with a current or historical diagnosis of cancer in the USA. Eur Heart J 41:2183–2193. https://doi.org/10.1093/eurheartj/ehz851

    Article  CAS  Google Scholar 

  13. Velders MA, Hagström E, James SK (2020) Temporal trends in the prevalence of cancer and its impact on outcome in patients with first myocardial infarction: a nationwide study. J Am Heart Assoc 9:e014383. https://doi.org/10.1161/JAHA.119.014383

    Article  CAS  Google Scholar 

  14. Ederhy S, Cohen A, Boccara F et al (2019) In-hospital outcomes and 5-year mortality following an acute myocardial infarction in patients with a history of cancer: results from the french registry on acute ST-elevation or non-ST-elevation myocardial infarction (FAST-MI) 2005 cohort. Arch Cardiovasc Dis 112:657–669. https://doi.org/10.1016/j.acvd.2019.06.012

    Article  Google Scholar 

  15. Itzhaki Ben Zadok O, Hasdai D, Gottlieb S et al (2019) Characteristics and outcomes of patients with cancer presenting with acute myocardial infarction. Coron Artery Dis 30:332–338. https://doi.org/10.1097/MCA.0000000000000733

    Article  Google Scholar 

  16. Gong IY, Yan AT, Ko DT et al (2018) Temporal changes in treatments and outcomes after acute myocardial infarction among cancer survivors and patients without cancer, 1995 to 2013. Cancer 124:1269–1278. https://doi.org/10.1002/cncr.31174

    Article  CAS  Google Scholar 

  17. Kurisu S, Iwasaki T, Ishibashi K et al (2013) Comparison of treatment and outcome of acute myocardial infarction between cancer patients and non-cancer patients. Int J Cardiol 167:2335–2337. https://doi.org/10.1016/j.ijcard.2012.11.009

    Article  Google Scholar 

  18. Rohrmann S, Witassek F, Erne P et al (2018) Treatment of patients with myocardial infarction depends on history of cancer. Eur Heart J Acute Cardiovasc Care 7:639–645. https://doi.org/10.1177/2048872617729636

    Article  Google Scholar 

  19. Hisada Y, Mackman N (2017) Cancer-associated pathways and biomarkers of venous thrombosis. Blood 130:1499–1506. https://doi.org/10.1182/blood-2017-03-743211

    Article  CAS  Google Scholar 

  20. Vincent L, Leedy D, Masri SC et al (2019) Cardiovascular disease and cancer: is there increasing overlap? Curr Oncol Rep 21:47. https://doi.org/10.1007/s11912-019-0796-0

    Article  Google Scholar 

  21. Lee JR, Park BW, Park JH et al (2021) Local delivery of a senolytic drug in ischemia and reperfusion-injured heart attenuates cardiac remodeling and restores impaired cardiac function. Acta Biomater 135:520–533. https://doi.org/10.1016/j.actbio

    Article  CAS  Google Scholar 

  22. Banerjee P, Kotla S, Reddy Velatooru L et al (2021) Senescence-associated secretory phenotype as a hinge between cardiovascular diseases and cancer. Front Cardiovasc Med 08:763930. https://doi.org/10.3389/fcvm.2021.763930

    Article  CAS  Google Scholar 

  23. Mena Sebastiá E, Tirapu Sola L, Villanueva Vázquez R et al (2021) Cancer, onco-haematological treatment and cardiovascular toxicity. Hipertens Riesgo Vasc 38:72–82. https://doi.org/10.1016/j.hipert.2020.08.001

    Article  Google Scholar 

  24. Tufano A, Coppola A, Galderisi M (2021) The growing impact of cardiovascular oncology: epidemiology and pathophysiology. Semin Thromb Hemost 47:899–906. https://doi.org/10.1055/s-0041-1729885

    Article  CAS  Google Scholar 

  25. Childs BG, Baker DJ, Wijshake T et al (2016) Senescent intimal foam cells are deleterious at all stages of atherosclerosis. Science 354:472–477. https://doi.org/10.1126/science.aaf6659

    Article  CAS  Google Scholar 

  26. Abdelgawad IY, Sadak KT, Lone DW et al (2021) Molecular mechanisms and cardiovascular implications of cancer therapy-induced senescence. Pharmacol Ther 221:107751. https://doi.org/10.1016/j.pharmthera.2020.107751

    Article  CAS  Google Scholar 

  27. Mukai M, Oka T (2018) Mechanism and management of cancer-associated thrombosis. J Cardiol 72:89–93. https://doi.org/10.1016/j.jjcc.2018.02.011

    Article  Google Scholar 

  28. Roule V, Verdier L, Blanchart K et al (2020) Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention. BMC Cardiovasc Disord 20:38. https://doi.org/10.1186/s12872-020-01352-0

    Article  Google Scholar 

  29. Birgegård G, Aapro MS, Bokemeyer C et al (2005) Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology 68(Suppl 1):3–11. https://doi.org/10.1159/000083128

    Article  Google Scholar 

  30. Bando YK (2021) Cancer and coronary heart disease-to bleed or not to bleed. That Question Circ J 85:847–849. https://doi.org/10.1253/circj.CJ-21-0174

    Article  Google Scholar 

  31. Kanenawa K, Yamaji K, Morinaga T et al (2021) Clinical outcomes after percutaneous coronary intervention in patients with cancer. Circ J 85:837–846. https://doi.org/10.1253/circj.CJ-20-1119

    Article  CAS  Google Scholar 

Download references

Funding

No funding was utilized for this study.

Author information

Authors and Affiliations

  1. Shandong University of Traditional Chinese Medicine, Jinan, China

    Xu Dongchen, Mu Xueping & Shan Jingjing

  2. Hospital of Chengdu University of Traditional Chinese Medicine, Jinan, China

    Li Tongyi

  3. Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, China

    Li Quanhong

Authors
  1. Xu Dongchen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li Tongyi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mu Xueping
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shan Jingjing
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li Quanhong
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

XDC and LTY conceived the study. MXP acquired, analyzed, and interpreted data. SJJ drafted the manuscript and revised the article for intellectual content. LQH reviewed the final draft and the publishing version. All authors gave final approval.

Corresponding author

Correspondence to Li Quanhong.

Ethics declarations

Conflict of interest

The authors reported no potential competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dongchen, X., Tongyi, L., Xueping, M. et al. Risk of mortality and other adverse outcomes from myocardial infarction in cancer survivors: a meta-analysis. Int J Clin Oncol 28, 41–51 (2023). https://doi.org/10.1007/s10147-022-02276-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-022-02276-9

Keywords

Search

Navigation