Prognostic analysis of acute myocardial infarction patients complicated with prostate cancer: a real-world study

Background Data on cardiovascular outcomes in patients with acute myocardial infarction (AMI) and concomitant prostate cancer (PCa) is scarce. Methods This was a retrospective cohort study of patients admitted to 72 secondary and tertiary hospitals in Tianjin between 2010 and 2023 using the Tianjin Health and Medical Big Data Platform. The primary outcome was major adverse cardiovascular events (MACEs) (all-cause death, recurrent myocardial infarction, or ischemic stroke). Propensity score matching (PSM) (1 : 3) was performed, and Cox regression was used to assess the long-term (5 years) and short-term (30 days) risks. Results A total of 100 708 male patients with an initial diagnosis of AMI were included, of whom 375 had PCa. Patients in the PCa group were older, had higher proportions of Killip classification III–IV and comorbidities, and lower proportions of optimal medical therapy (OMT) and percutaneous coronary intervention (PCI) during hospitalization (all P < 0.001). In the PSM cohort, the PCa group had a higher 5-year MACE rate than the non-PCa group (48.3% vs. 42.2%; P = 0.043). Kaplan–Meier analysis showed a significant difference in 5-year cumulative MACE events ( P = 0.012) between the two groups, mainly attributed to all-cause mortality events ( P = 0.005). Multivariable Cox regression showed that PCa was a risk factor for 5-year MACE events, whereas PCI and antiplatelet agents were protective factors. Conclusion AMI patients complicated with PCa have a higher burden of cardiovascular disease, lower rates of OMT and PCI, and a higher risk of long-term adverse cardiovascular events and mortality.