Abstract PS7-26: Acute myocardial infarction prevalence and trends in females with active breast cancer

Abstract

Abstract Introduction:Breast cancer is among the three most common malignancies worldwide, and a better understanding of the epidemiology of the cardiovascular disease in females with breast cancer is needed Methods:Females with active breast cancer diagnosis hospitalized from January 2010 to December2017 were identified in the Nationwide Readmissions Database. Outcomes of interest were the prevalence of acute myocardial infarction (AMI), non-ST-segment myocardial infarction (NSTEMI), cardiac complications, and in-hospital mortality.Results:1,424,102 females with breast cancer were identified. Of whom, 17,578 (1.23%) were hospitalized for AMI. AMI patients were older with a mean age of 72.51 (11.73) vs. 62.22 (14.29), p<0.001. AMI patients had a higher prevalence of hypertension; 65.3% vs. 47.3%, p<0.001, known coronary artery disease; 51.1% vs. 8.2%, p<0.001, hyperlipidemia; 46.6% vs. 24.2%, p<0.001, known heart failure; 42.6% vs. 8.8%, p<0.001, smoking; 26.7% vs. 21.6%, p<0.001, history of stroke; 6.2% vs. 3.2%, p<0.001, history of prior AMI; 9.5% vs. 2.3%, p<0.001, and diabetes with chronic complications; 11.0% vs. 4.2%, p<0.001, and diabetes without complications; 25.2% vs. 15.8%, p<0.001. Over the 8 years, the prevalence of cardiovascular risk factors increased in breast cancer patients including; diabetes with chronic complications; from 2.3% in 2010 to 10.4% in 2017, p-trend<0.001, obesity; 7.8% in 2010 to 13.3% in 2017, p-trend<0.001, coronary artery disease; 8.1% in 2010 to 10.2% in 2017, p-trend<0.001, hyperlipidemia; 20.7% in 2010 to 29.7% in 2017, p-trend<0.001, and smoking; 16.8% in 2010 to 28.2% in 2017, p-trend<0.001. AMI increased over the study duration from 1.0% in 2010 to 1.8% in 2017, p-trend<0.001, and NSTEMI increased from 0.8% in 2010 to 1.5% in 2017, p-trend<0.001. The observed increase was persistent when patients with localized malignancies were examined with AMI inclining from 2.1% in 2010 to 2.4% in 2017, p-trend<0.001, and NSTEMI from 1.6% in 2010 to 2.0% in 2017, p-trend<0.001. Breast cancer patients with AMI had a higher hospital mortality rate; 14.7% vs. 4.2%, OR: 3.96, 95% CI (3.80-4.13), p<0.001, cardiac arrest; 3.9% vs. 0.5%, OR: 8.53, 95% CI (7.87-9.24), p<0.001, and cardiogenic shock, 5.1% vs. 0.1%, OR: 42.03, 95% CI (38.73-45.60), p<0.001.Conclusion:Females with breast cancer have a concerning prevalence of cardiovascular disease with stern worse outcomes, and the prevalence is shown to be increasing over the study duration. Known cardiovascular risk factors are also increasing in breast cancer patients. Further efforts should be directed to aggressively reduce the prevalence of modifiable risk factors in order to improve the outcomes of breast cancer patients. 20102011201220132014201520162017P-trendCoronary Artery Disease8.1%8.3%8.0%8.5%8.9%8.1%9.7%10.2%<0.001Diabetes with chronic complications2.3%2.5%2.5%2.9%3.3%3.9%7.2%10.4%<0.001Heart Failure7.8%7.8%7.9%8.5%9.5%9.0%11.3%12.5%<0.001Hyperlipidemia20.7%21.9%22.8%24.6%25.8%23.1%28.0%29.7%<0.001Obesity7.8%8.7%9.8%11.2%12.2%12.2%12.2%13.3%<0.001Smoking16.8%17.2%19.0%20.7%23.2%22.2%27.6%28.2%<0.001OutcomesAMIOverall1.0%1.0%1.1%1.1%1.3%1.2%1.5%1.8%<0.001Localized Malignancies2.1%1.9%2.0%2.0%2.1%1.8%2.0%2.4%<0.001Patients with History of Radiation Therapy1.2%0.7%1.1%0.7%1.2%1.2%1.6%1.6%<0.001History of prior AMI3.5%3.6%4.2%4.7%5.5%4.3%6.6%6.5%<0.001NSTEMIOverall0.8%0.8%0.9%0.9%1.0%1.0%1.3%1.5%<0.001Localized Malignancies1.6%1.5%1.6%1.6%1.7%1.5%1.7%2.0%<0.001Patients with History of Radiation Therapy0.9%0.6%0.9%0.6%0.9%1.0%1.5%1.3%<0.001History of prior AMI3.0%2.5%3.8%3.7%4.5%3.9%5.7%5.6%<0.001 Citation Format: Mohamed M Gad, Anas M Saad. Acute myocardial infarction prevalence and trends in females with active breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-26.