Cancer patients less likely to receive life-saving therapy when suffering a heart attack

A major study of nearly 2 million heart attack patients has found that many who also had cancer were not offered a potentially lifesaving treatment, despite the fact it had major benefits.

The international research team, led by Keele's Professor Mamas Mamas and the Keele Cardiovascular Research Group, analyzed data from 1.8 million patients who presented with a ST-elevation myocardial infarction (STEMI) - a type of heart attack -to investigate whether patients who also have cancer gain as much benefit from receiving a treatment called Percutaneous Coronary Intervention, as those without cancer during their heart attack.

A PCI is alife saving coronary stent procedure, but it is often not administered to cancer patients as much of the existing research into the effectiveness of PCI treatments excluded patients with cancer, and these patients may be at increased risk from procedural complications such as major bleeding.

Previous work has showed that patients with cancer have an increased risk of developing a heart attack, particularly within the first month of diagnosis where the risk is greatest. This may be because some of the treatments used in patients with cancer can increase the risk of heart attack, and patients that develop cancer share many of the risk factors known to increase the risk of developing a heart attack like smoking, obesity and diabetes.

The current study, published in the European Heart Journal-Acute Cardiovascular Care, looked at patients with a variety of different cancer types including blood, breast, colon, lung and prostate cancer, and found that these patients were up to 50% less likely to receive a PCIwhen suffering a heart attack, compared to heart patients without cancer.

Despite this, the researchers also found that for those who were offered the treatment, the benefits were just as great as they were for patients without cancer, and Professor Mamas said this work strongly supports the case for offering PCI treatments to more heart attack patients with cancer.

This research is important as patients with cancer are potentially not receiving life-saving therapy, and yet we showed that they derive as much if not more benefit than patients without cancer. Our future work will focus on longer-term outcomes in this population."

Professor Mamas Mamas, Keele University

Source:
Journal reference:

Mohamed, M.O., et al. (2021) Effect of primary percutaneous coronary intervention on in-hospital outcomes among active cancer patients presenting with ST-elevation myocardial infarction: a propensity score matching analysis. European Heart Journal. Acute Cardiovascular Care. doi.org/10.1093/ehjacc/zuaa032.

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