P3455Trends, untilization of therapies and outcomes of females with history of breast cancer admitted for STEMI

Abstract

Abstract Background Real world experience of treatment of female patient with history of breast cancer suffering from STEMI is lacking Purpose To study the trends, utilization of therapies and outcomes of STEMI in females with history of breast cancer from a large, national, multicenter US database. Methods We analyzed Nationwide Inpatient Sample from years 2007 to 2014 to identify all females with primary discharge diagnosis of STEMI and secondary diagnosis of breast cancer. We then analyzed the use of various therapies and outcomes. Results Of 476,462 females with STEMI hospitalizations, 17, 357 (3.65%) had history of breast cancer. In this patient cohort the mean age was 75.81±11.82 years and 85% were Caucasians, hypertension, diabetes mellitus, chronic kidney disease and peripheral vascular disease was present in 29.5%, 70.3%, 12.4% and 8.3% respectively. 50% of the patients underwent percutaneous coronary intervention (PCI) and 3% underwent coronary artery bypass surgery (CABG). Intra-aortic balloon pump was used in 5.2% and percutaneous LVAD (PLVAD) in 0.5%. 15.3% patients developed cardiogenic shock (CS) and 6.2% had ventricular fibrillation/cardiac arrest (Vfib/CA). The in-hospital mortality was 12.3%. Comparison of female patients for STEMI with and without history of breast cancer Group Patients No Age (mean) PCI CABG IABP PLVAD CS Vfib/CA Mortality STEMI / Breast cancer − 495,105 69±14 54% 4.5% 6.5% 3% 9.42% 8.1% 9.7% STEMI / Breast cancer + 17,357 75.8±11.8* 50%* 3%* 5.2%* 0.5%* 15.3%* 6.2%* 12.3%* *P<0.05. Conclusion The STEMI/breast cancer cohort is significantly older with underutilization of PCI, CABG, and mechanical circulatory support. This population exhibits higher mortality rates. Acknowledgement/Funding None