Association between cardiovascular disease and a history of cancer in patients with chest pain on the fast track outpatient clinic
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Why the study?
It is unknown how cancer survivors who underwent cardiotoxic therapies should be monitored, prompting investigation into their prevalence, long-term survival, and cardiovascular outcomes among patients presenting with chest pain for CTA.
Does a history of malignancy affect long-term survival and cardiovascular outcomes in patients with chest pain referred for computed tomography angiography?
Population
1,892 patients with chest pain who underwent computed tomography angiography
Comparison
History of malignancy vs no history of malignancy
Design
Observational cohort study
Follow-up
ten years
Authors
Discussion
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Implication
Higher mortality and CAC in cancer survivors referred for CTA warrant caution in monitoring; leaves open optimal surveillance strategies.
Structured PICO
Does a history of malignancy affect long-term survival and cardiovascular outcomes in patients with chest pain referred for computed tomography angiography?
P
Population
1,892 adult patients (>18 years) with symptoms of chest pain referred for computed tomography angiography at a single center in the Netherlands. 133 (7%) had a history of malignancy and 1,759 (93%) did not.
I
Intervention
History of malignancy (observational exposure)
C
Comparator
No history of malignancy
O
Outcome
Long-term survival (all-cause mortality) at median 7 years follow-uphard clinical
In patients with chest pain referred for CTA, a history of malignancy is associated with higher long-term mortality, higher CAC percentiles, and more incidental malignancies, but not with an increased prevalence of obstructive CAD.
Limitations
- Retrospective observational study design (cannot prove causality)
- Only data on all-cause mortality, not disease-specific mortality
- Did not analyze the effects of specific cancer therapies
Cite This Study
Sharma et al. (2019) studied this question.
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