OBJECTIVE
To analyze the features of comorbidities and their effect on prognosis in cancer patients hospitalized with acute coronary syndrome (ACS).
MATERIAL AND METHODS
The study was conducted in 3 stages. At the 1st stage, 2 groups of ACS patients were formed: the main group (n=88) — ACS with cancer (verification of cancer within previous 10 years), the control group (n=88) — ACS without cancer. Mean age of patients was 66.6±9.5 years. Men prevailed (57%). ACS without ST elevation was diagnosed in 60% of patients. At the 2nd stage, we assessed therapeutic comorbidities in patients with ACS and cancer. At the 3rd stage, we evaluated their impact on the incidence of in-hospital and long-term adverse events in these patients. Differences were considered significant at p-value <0.05.
RESULTS AND DISCUSSION
The most common comorbidities in patients with ACS and cancer were hypertension (100%), chronic kidney disease (24%, GFR 44.4±11.2 ml/min/1.73 m2), anemia (35%, HGB 93.4±19.3 g/l), type 2 diabetes mellitus (22%), obesity (27%, BMI 33.5±3.2 kg/m2), COPD (18%). Risk factors were dyslipidemia (73%), smoking (35%). CKD (p=0.08) and anemia (p=0.0002) were more common in patients with ACS and cancer compared to those without cancer. Comorbid background in ACS patients with active and previous cancer had no significant differences. In-hospital urgent complications were diagnosed in 39% of patients with ACS and cancer (n=34). Risk of these events was associated with active cancer (OR 2.3497 95% CI 0.9753—5.6606, p=0.05) and COPD (OR 3.2407 95% CI 0.8704—12.0668, p=0.07). In-hospital mortality and/or recurrent myocardial infarction were observed in 11% (n=10) of patients, long-term events (throughout 6 months) — in 28% (n=21) of patients with ACS and cancer. Anemia significantly increased the risk of in-hospital mortality and/or recurrent MI in these patients (OR 4.6579 95% CI 1.1875—18.2707, p=0.027).
CONCLUSION
Comorbid status should be considered to determine the optimal management of patients with ACS and cancer.
