Breast cancer and coronary artery disease: insights from a national inpatient sample analysis

BACKGROUND: The association between breast cancer and coronary artery disease (CAD) remains important because of shared cardiovascular risk factors, potential cardiotoxic effects of cancer therapy, and the growing population of breast cancer survivors. OBJECTIVE: To evaluate whether women with active or prior breast cancer have higher odds of CAD-related hospitalization using a nationally representative inpatient database. METHODS: We conducted a retrospective analysis of the 2016-2019 National Inpatient Sample. Adult women aged 18 years or older with active or prior breast cancer were compared with women without breast cancer. The study included 589,940 unweighted breast cancer hospitalizations, representing 2,949,699 weighted hospitalizations, matched to an equal number of controls. Propensity score matching and multivariable logistic regression were used to adjust for demographic and clinical confounders, including hypertension, diabetes, chronic kidney disease, smoking, obesity, dyslipidemia, and prior myocardial infarction. RESULTS: Breast cancer was not associated with increased odds of CAD-related hospitalization. In the unmatched cohort, breast cancer was associated with lower odds of CAD hospitalization (OR 0.84; 95% CI 0.84-0.85), attenuating after matching (OR 0.99; 95% CI 0.98-0.99). Lower odds were also observed for STEMI and NSTEMI hospitalizations. CONCLUSION: Breast cancer was not associated with increased odds of CAD-related hospitalization.