Determinants of cancer mortality in patients after acute myocardial infarction

To identify factors and preexisting conditions that are associated with overall cancer mortality, lung cancer mortality, and gastrointestinal cancer mortality in patients after acute myocardial infarction (AMI).

In total 10,718 AMI patients aged 25 to 74 years were evaluated. All cases of AMI that occurred in the study region of the population-based Myocardial Infarction Registry Augsburg during the period from 2000 to 2017 were analyzed. Median follow-up time was 6.6 years (IQR 2.8-11.2). Multivariable Cox regression models were calculated for overall cancer mortality (ICD-10: C00-D48), lung cancer mortality (C34), and gastrointestinal cancer mortality (C15-C25).

During the study period, 633 patients died from cancer, including 155 deaths from lung cancer and 212 deaths from gastrointestinal cancer. Higher age, current smoking and diabetes were associated with an increased cancer mortality risk in patients after AMI, whereas female sex, never smoking and platelet aggregation inhibitor intake were inversely related to overall cancer mortality. Higher lung cancer mortality in patients after AMI was linked with advanced age and current smoking. For gastrointestinal cancer death in patients after AMI age, diabetes and current smoking were associated with higher risk, whereas female sex, never smoking, platelet aggregation inhibitor and statin intake were inversely associated.

Factors already known for preventing cardiovascular disease were inversely associated with cancer mortality after AMI. These findings support the importance of comprehensive patient education regarding a healthy lifestyle following AMI. Overall, physicians targeting secondary prevention after AMI can also highlight the positive effects of these measures on cancer mortality.