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Myocardial infarction and future risk of cancer in the general population—the Tromsø Study

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Abstract

The association between myocardial infarction (MI) and future risk of incident cancer is scarcely investigated. Therefore, we aimed to study the risk of cancer after a first time MI in a large cohort recruited from a general population. Participants in a large population-based study without a previous history of MI or cancer (n = 28,763) were included and followed from baseline to date of cancer, death, migration or study end. Crude incidence rates (IRs) and hazard ratios (HRs) for cancer after MI were calculated. During a median follow-up of 15.7 years, 1747 subjects developed incident MI, and of these, 146 suffered from a subsequent cancer. In the multivariable-adjusted model (adjusted for age, sex, BMI, systolic blood pressure, diabetes mellitus, HDL cholesterol, smoking, physical activity and education level), MI patients had 46% (HR 1.46; 95% CI: 1.21–1.77) higher hazard ratio of cancer compared to those without MI. The increased cancer incidence was highest during the first 6 months after the MI, with a 2.2-fold higher HR (2.15; 95% CI: 1.29–3.58) compared with subjects without MI. After a 2-year period without higher incidence rate, MI patients displayed 60% (HR 1.60; 95% CI: 1.27–2.03) higher HR of future cancer more than 3 years after the event. The increased IRs were higher in women than men. Patients with MI had a higher short- and long-term incidence rate of cancer compared to subjects without MI. Our findings suggest that occult cancer and shared risk factors of MI and cancer may partly explain the association.

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References

  1. White HD, Chew DP. Acute myocardial infarction. Lancet. 2008;372(9638):570–84.

    Article  CAS  PubMed  Google Scholar 

  2. Pehrsson SK, Linnersjo A, Hammar N. Cancer risk of patients with ischaemic syndromes. J Intern Med. 2005;258(2):124–32.

    Article  CAS  PubMed  Google Scholar 

  3. Dreyer L, Olsen JH. Cancer risk of patients discharged with acute myocardial infarct. Epidemiology. 1998;9(2):178–83.

    Article  CAS  PubMed  Google Scholar 

  4. Lip GY, Chin BS, Blann AD. Cancer and the prothrombotic state. Lancet Oncol. 2002;3(1):27–34.

    Article  CAS  PubMed  Google Scholar 

  5. Naschitz JE, Yeshurun D, Abrahamson J, Eldar S, Chouri H, Kedar S, et al. Ischemic heart disease precipitated by occult cancer. Cancer. 1992;69(11):2712–20.

    Article  CAS  PubMed  Google Scholar 

  6. Warren GW, Alberg AJ, Kraft AS, Cummings KM. The 2014 Surgeon General’s report: “The health consequences of smoking–50 years of progress”: a paradigm shift in cancer care. Cancer. 2014;120(13):1914–6.

    Article  PubMed  Google Scholar 

  7. Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640–9.

    Article  PubMed  Google Scholar 

  8. Bianchini F, Kaaks R, Vainio H. Overweight, obesity, and cancer risk. Lancet Oncol. 2002;3(9):565–74.

    Article  PubMed  Google Scholar 

  9. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Morganti M, Carpi A, Nicolini A, Gorini I, Glaviano B, Fini M, et al. Atherosclerosis and cancer: common pathways on the vascular endothelium. Biomed Pharmacother. 2002;56(7):317–24.

    Article  CAS  PubMed  Google Scholar 

  11. Ross JS, Stagliano NE, Donovan MJ, Breitbart RE, Ginsburg GS. Atherosclerosis and cancer: common molecular pathways of disease development and progression. Ann N Y Acad Sci. 2001;947:271–93.

    Article  CAS  PubMed  Google Scholar 

  12. Colotta F, Allavena P, Sica A, Garlanda C, Mantovani A. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis. 2009;30(7):1073–81.

    Article  CAS  PubMed  Google Scholar 

  13. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352(16):1685–95.

    Article  CAS  PubMed  Google Scholar 

  14. Jacobsen BK, Eggen AE, Mathiesen EB, Wilsgaard T, Njolstad I. Cohort profile: the Tromso study. Int J Epidemiol. 2012;41(4):961–7.

    Article  PubMed  Google Scholar 

  15. The Norwegian Institute of Public Health. Overweight and obesity in Norway: fact sheet. http://www.fhi.no/eway/default.aspx?pid=240&trg=List_6673&Main_6664=6894:0:25,7585:1:0:0:::0:0&MainContent_6894=6671:0:25,7612:1:0:0:::0:0&List_6673=6674:0:25,7616:1:0:0:::0:0. Accessed 26 Feb 2015.

  16. WHO MONICA Project. MONICA Manual.http://www.thl.fi/publications/monica/index.html. Accessed 26 Feb 2015.

  17. Larsen IK, Smastuen M, Johannesen TB, Langmark F, Parkin DM, Bray F, et al. Data quality at the cancer registry of Norway: an overview of comparability, completeness, validity and timeliness. Eur J Cancer. 2009;45(7):1218–31.

    Article  PubMed  Google Scholar 

  18. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–322.

    Article  PubMed  Google Scholar 

  19. Zoller B, Ji J, Sundquist J, Sundquist K. Risk of coronary heart disease in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer. 2012;48(1):121–8.

    Article  PubMed  Google Scholar 

  20. Hansen ES. International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC Working Paper 7/1/2. Shared risk factors for cancer and atherosclerosis–a review of the epidemiological evidence. Mutat Res. 1990;239(3):163–79.

  21. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328(7455):1519.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.

    Article  PubMed  Google Scholar 

  23. Caine GJ, Stonelake PS, Lip GY, Kehoe ST. The hypercoagulable state of malignancy: pathogenesis and current debate. Neoplasia. 2002;4(6):465–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Ridker PM, Hennekens CH, Lindpaintner K, Stampfer MJ, Eisenberg PR, Miletich JP. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. N Engl J Med. 1995;332(14):912–7.

    Article  CAS  PubMed  Google Scholar 

  25. Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med. 1995;332(10):635–41.

    Article  CAS  PubMed  Google Scholar 

  26. Girolami A, Simioni P, Scarano L, Girolami B. Venous and arterial thrombophilia. Haematologica. 1997;82(1):96–100.

    CAS  PubMed  Google Scholar 

  27. Heit JA. Thrombophilia: common questions on laboratory assessment and management. Hematol Am Soc Hematol Educ Program. 2007;2007(1):127–35.

    Google Scholar 

  28. Middeldorp S, van Hylckama Vlieg A. Does thrombophilia testing help in the clinical management of patients? Br J Haematol. 2008;143(3):321–35.

    Article  PubMed  Google Scholar 

  29. de Moerloose P, Boehlen F. Inherited thrombophilia in arterial disease: a selective review. Semin Hematol. 2007;44(2):106–13.

    Article  PubMed  Google Scholar 

  30. Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917):868–74.

    Article  CAS  PubMed  Google Scholar 

  31. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–44.

    Article  CAS  PubMed  Google Scholar 

  32. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Erichsen R, Svaerke C, Sorensen HT, Sandler RS, Baron JA. Risk of colorectal cancer in patients with acute myocardial infarction and stroke: a nationwide cohort study. Cancer Epidemiol Biomark Prev. 2013;22(11):1994–9.

    Article  Google Scholar 

  34. Reicher-Reiss H, Jonas M, Goldbourt U, Boyko V, Modan B. Selectively increased risk of cancer in men with coronary heart disease. Am J Cardiol. 2001;87(4):459–62.

    Article  CAS  PubMed  Google Scholar 

  35. Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet. 2011;377(9759):31–41.

    Article  CAS  PubMed  Google Scholar 

  36. Rothwell PM, Price JF, Fowkes FG, Zanchetti A, Roncaglioni MC, Tognoni G, et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet. 2012;379(9826):1602–12.

    Article  CAS  PubMed  Google Scholar 

  37. Rothwell PM, Wilson M, Price JF, Belch JF, Meade TW, Mehta Z. Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Lancet. 2012;379(9826):1591–601.

    Article  CAS  PubMed  Google Scholar 

  38. Cardwell CR, Hicks BM, Hughes C, Murray LJ. Statin use after colorectal cancer diagnosis and survival: a population-based cohort study. J Clin Oncol. 2014;32(28):3177–83.

    Article  PubMed  Google Scholar 

  39. Cardwell CR, Mc Menamin U, Hughes CM, Murray LJ. Statin use and survival from lung cancer: a population-based cohort study. Cancer Epidemiol Biomark Prev. 2015;24(5):833–41.

    Article  CAS  Google Scholar 

  40. Graaf MR, Beiderbeck AB, Egberts AC, Richel DJ, Guchelaar HJ. The risk of cancer in users of statins. J Clin Oncol. 2004;22(12):2388–94.

    Article  CAS  PubMed  Google Scholar 

  41. Chang CC, Ho SC, Chiu HF, Yang CY. Statins increase the risk of prostate cancer: a population-based case-control study. Prostate. 2011;71(16):1818–24.

    Article  CAS  PubMed  Google Scholar 

  42. Goldstein MR, Mascitelli L, Pezzetta F. Do statins prevent or promote cancer? Curr Oncol. 2008;15(2):76–7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Ravnskov U, Rosch PJ, McCully KS. Statins do not protect against cancer: quite the opposite. J Clin Oncol. 2015;33(7):810–1.

    Article  CAS  PubMed  Google Scholar 

  44. Baron JA, Gridley G, Weiderpass E, Nyren O, Linet M. Venous thromboembolism and cancer. Lancet. 1998;351(9109):1077–80.

    Article  CAS  PubMed  Google Scholar 

  45. Sorensen HT, Mellemkjaer L, Steffensen FH, Olsen JH, Nielsen GL. The risk of a diagnosis of cancer after primary deep venous thrombosis or pulmonary embolism. N Engl J Med. 1998;338(17):1169–73.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The study has used data from the Cancer Registry of Norway. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway is intended nor should be inferred. K.G. Jebsen TREC is supported by an independent grant from the K.G. Jebsen Foundation.

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Authors and Affiliations

  1. K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Ludvig B. Rinde, Birgit Småbrekke, Erin M. Hald, Ellen E. Brodin, Inger Njølstad, Ellisiv B. Mathiesen, Sigrid K. Brækkan, Anders Vik & John-Bjarne Hansen

  2. Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

    Erin M. Hald, Ellen E. Brodin, Sigrid K. Brækkan, Anders Vik & John-Bjarne Hansen

  3. Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Inger Njølstad, Maja-Lisa Løchen & Tom Wilsgaard

  4. Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Ellisiv B. Mathiesen

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  1. Ludvig B. Rinde
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Correspondence to Ludvig B. Rinde.

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Rinde, L.B., Småbrekke, B., Hald, E.M. et al. Myocardial infarction and future risk of cancer in the general population—the Tromsø Study. Eur J Epidemiol 32, 193–201 (2017). https://doi.org/10.1007/s10654-017-0231-5

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