Cancer history and mortality risk in acute myocardial infarction: Insights from the Japan AMI registry

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-05-08 DOI:10.1016/j.ijcha.2025.101695

Ayumi Adachi , Kazuma Oyama , Jun Takahashi , Satoshi Honda , Kensaku Nishihira , Sunao Kojima , Misa Takegami , Yasuhide Asaumi , Jun Yamashita , Mike Saji , Kiyoshi Hibi , Yasuhiko Sakata , Morimasa Takayama , Tetsuya Sumiyoshi , Hisao Ogawa , Kazuo Kimura , Satoshi Yasuda

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引用次数: 0

Abstract

Background

The association between a history of cancer and clinical outcomes in patients with acute myocardial infarction (AMI) remains unclear. This study aimed to analyze the characteristics and clinical outcomes of AMI patients based on their history of cancer in a contemporary cohort undergoing antithrombotic therapy with potent P2Y₁₂ inhibitors.

Methods

Consecutive patients with spontaneous onset were enrolled in the Japan AMI Registry (JAMIR), a multi-center, nationwide prospective registry. The outcomes included all-cause death, major bleeding, and composite ischemic events defined as cardiovascular (CV) death, MI, and ischemic stroke.

Results

A total of 3,411 AMI patients were enrolled with a median follow-up duration of 358 days. Among those, 292 patients (8.6 %) had a history of cancer. They were older and had lower body mass index. While they had a similar risk of composite ischemic event and major bleeding, they were at higher risk for all-cause mortality than those without (adjHR 1.64 [95 %CI 1.16–2.32], P = 0.005). The risk for non-CV death and death due to cancer were higher in the cancer group (adjHR 2.05 [1.24–3.39], P = 0.005; adjHR 18.16 [6.76–48.97], P < 0.001, respectively). When further stratified by age, the difference in all-cause mortality became pronounced in the group aged < 75 years but not in the group aged ≥ 75 years (adjHR 3.32 [1.88–5.85] and 1.26 [0.81–1.96], respectively; P-interaction = 0.008).

Conclusion

The JAMIR demonstrated that a history of cancer was associated with increased mortality in AMI patients aged < 75 years. These results might suggest the need for a multidisciplinary approach to improve their prognosis.

Abstract Image

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急性心肌梗死的癌症病史和死亡风险：来自日本AMI登记的见解

背景：急性心肌梗死（AMI）患者的癌症病史与临床结果之间的关系尚不清楚。本研究旨在分析当代队列中接受强效P2Y12抑制剂抗血栓治疗的AMI患者的特征和临床结果。方法自发性发作的连续患者入组日本AMI注册中心（JAMIR），这是一个多中心、全国性的前瞻性注册中心。结果包括全因死亡、大出血和复合缺血性事件，定义为心血管（CV）死亡、心肌梗死和缺血性卒中。结果共纳入3411例AMI患者，中位随访时间为358天。其中292例（8.6%）有癌症病史。他们年龄更大，身体质量指数更低。虽然他们有相似的复合缺血性事件和大出血的风险，但他们的全因死亡率比没有的人高（adjHR 1.64 [95% CI 1.16-2.32], P = 0.005）。癌症组非cv死亡和因癌死亡的风险较高(adjHR 2.05 [1.24-3.39], P = 0.005；[6.76-48.97], P <；分别为0.001)。当进一步按年龄分层时，全因死亡率的差异在年龄组中变得明显。75岁，≥75岁组无(adjHR分别为3.32[1.88-5.85]和1.26 [0.81-1.96]；p -相互作用= 0.008)。结论JAMIR表明，老年AMI患者的癌症病史与死亡率增加相关。75年。这些结果可能提示需要多学科的方法来改善他们的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.