Русский
Peculiarities of the clinical course of myocardial infarction associated with malignant neoplasms of various stages and localizations at the hospital period
DOI: https://dx.doi.org/10.18565/therapy.2024.8.50-56
Skorodumova E.G., Skorodumova E.A., Kostenko V.A., Siverina A.V.
I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care
The aim: to identify the peculiarities of myocardial infarction (MI) clinical course in patients with malignant neoplasms (MN) in multidisciplinary hospital conditions.
Material and methods. Medical records of 456 patients treated at I.I. Dzhanelidze research institute of emergency care from 2017 to 2022 with MI associated with MN were processed. Patients were divided into three groups: I – with MI and a history of cancer (n = 162), II – with MI and current oncological process (n = 194), III (control) – with MI without MN (n = 100). Gender, age, presence/absence of ST segment elevation on electrocardiogram (ECG), class of acute heart failure (AHF) according to Killip, functional classes of heart failure, cardiac arrhythmias, type of malignant neoplasm, and hospital mortality were assessed.
Results. In patients with current oncological process, MI with ST segment elevation was more commonly occured, in those with previous malignant neoplasm more commonly occured MI without ST segment elevation. In the latter, AHF was often not detected, while AHF of Killip classes 2–4 developed with greater frequency in patients of group II. The percentage of patients with chronic kidney disease stages 3b–4 was higher (38.7%) in the sample of patients with active malignant neoplasms, while among patients with previous malignant neoplasms it was 20.9%, and in those with MI without malignant neoplasm – 15%.
Conclusion. Patients with active malignant neoplasms had such features of MI course as a higher prevalence of ST-segment elevation on the ECG and more severe acute heart failure; in addition, they most often had gastrointestinal malignant neoplasms. Patients with a history of cancer more often did not have acute heart failure and had a not often variant of MI with ST-segment elevation.
Literature
1. Araujo F., Gouvinhas C., Fontes F. et al. Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980–2010). Eur J Prev Cardiol. 2014; 21(8): 1004–17. https://doi.org/10.1177/2047487313497864. PMID: 23884980. 2. Аверков О.В., Дупляков Д.В., Гиляров М.Ю. с соавт. Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25(11): 251–310. (Averkov O.V., Duplyakov D.V., Gilyarov M.Yu. et al. 2020 clinical practice guidelines for acute ST-segment elevation myocardial infarction. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020; 25(11): 251–310 (In Russ.)). https://doi.org/10.15829/1560-4071-2020-4103. EDN: KNQWWK. 3. Барбараш О.Л., Дупляков Д.В., Затейщиков Д.А. с соавт. Острый коронарный синдром без подъема сегмента ST электрокардиограммы. Клинические рекомендации 2020. Российский кардиологический журнал. 2021; 26(4): 149–202. (Barbarash O.L., Duplyakov D.V., Zateishchikov D.A. et al. 2020 clinical practice guidelines for acute coronary syndrome without ST segment elevation. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021; 26(4): 149–202 (In Russ.)). https://doi.org/10.15829/1560-4071-2021-444. EDN: BSXPMI. 4. Authors/Task Force members; Windecker S., Kolh P., Alfonso F. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2014; 35(37): 2541–619. https://doi.org/10.1093/eurheartj/ehu278. PMID: 25173339. 5. Hancock S.L., Donaldson S.S., Hoppe R.T. Cardiac disease following treatment of Hodgkin’s disease in children and adolescents. J Clin Oncol. 1993; 11(7): 1208–15. https://doi.org/10.1200/jco.1993.11.7.1208. PMID: 8315419. 6. Dafaalla M., Abdel-Qadir H., Gale C.P. et al. Outcomes of ST elevation myocardial infarction in patients with cancer: A nationwide study. Eur Heart J Qual Care Clin Outcomes. 2023; 9(8): 806–17. https://doi.org/10.1093/ehjqcco/qcad012. PMID: 36921979. 7. Ederhy S., Cohen A., Boccara F. et al. 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. 2019; 112(11): 657–69. https://doi.org/10.1016/j.acvd.2019.06.012. PMID: 31761740. 8. Лубоятникова Е.С., Киселев А.Р., Комарова М.В. с соавт. Инфаркт миокарда с подъемом сегмента ST у пациентов со злокачественными новообразованиями. Кардиология. 2018; 58(12): 5–12. (Luboyatnikova E.S., Kiselev A.R., Komarova M.V. et al. ST-elevation myocardial infarction in patients with malignancies. Kardiologiya = Cardiology. 2018; 58(12): 5–12 (In Russ.)). https://doi.org/10.18087/cardio.2018.12.10204. EDN: YQZOJN. 9. Marshall V.K., Given B.A. Factors associated with medication beliefs in patients with cancer: An integrative review. Oncol Nurs Forum. 2018; 45(4): 508–26. https://doi.org/10.1188/18.ONF.508-526. PMID: 29947359. 10. Guddati A.K., Joy P.S., Kumar G. Analysis of outcomes of percutaneous coronary intervention in metastatic cancer patients with acute coronary syndrome over a 10-year period. J Cancer Res Clin Oncol. 2016; 142(2): 471–79. https://doi.org/10.1007/s00432-015-2056-5. PMID: 26498773. 11. Velders M.A., Boden H., Hofma S.H. et al. Outcome after ST elevation myocardial infarction in patients with cancer treated with primary percutaneous coronary intervention. Am J Cardiol. 2013; 112(12): 1867–72. https://doi.org/10.1016/j.amjcard.2013.08.019. PMID: 24063839. 12. Makar G.A., Holmes J.H., Yang Y.X. Angiotensin-converting enzyme inhibitor therapy and colorectal cancer risk. J Natl Cancer Inst. 2014; 106(2): 374–78. https://doi.org/10.1093/jnci/djt374. PMID: 24431411. PMCID: PMC3952198. 13. Richard P.O., Ahmad A.E., Bashir S. et al. Effect of statins as a secondary chemopreventive agent among individuals with non-muscle-invasive bladder cancer: A population-based analysis. Urol Oncol. 2017; 35(6): 342–48. https://doi.org/10.1016/j.urolonc.2016.12.009. PMID: 28190747. 14. Kurisu S., Iwasaki T., Ishibashi K. et al. Comparison of treatment and outcome of acute myocardial infarction between cancer patients and non-cancer patients. Int Cardiol J. 2013; 167(5): 2335–37. https://doi.org/10.1016/j.ijcard.2012.11.009. PMID: 23201078.
About the Autors
Elizaveta G. Skorodumova, MD, PhD (Medicine), senior researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3 Budapestskaya St.
E-mail: lisavetta91@mail.ru
ORCID: https://orcid.org/0000-0002-4961-5570
Elena A. Skorodumova, MD, Dr. Sci. (Medicine), leading researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3 Budapestskaya St.
E-mail: elskor@mail.ru
ORCID: https://orcid.org/0000-0002-5017-0214
Viktor A. Kostenko, MD, Dr. Sci. (Medicine), head of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3 Budapestskaya St.
E-mail: vic2012tor@gmail.com
ORCID: https://orcid.org/0000-0002-7015-1010
Anna V. Siverina, MD, PhD (Medicine), researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3 Budapestskaya St.
E-mail: gudkovanna_09@mail.ru
ORCID: https://orcid.org/0000-0002-6831-2153
Similar Articles
