Key result
Patients with mild to moderate ischaemic syndromes (AMI, AP, IC) had an increased risk of cancer (e.g., AMI men SIR 1.08; 95% CI 1.04-1.11), whereas those undergoing revascularization did not.
Why the study?
Does the presence of ischaemic syndromes alter the risk of developing cancer compared to the general population?
Cohort (n=63,921)
Does the presence of ischaemic syndromes alter the risk of developing cancer compared to the general population?
Patients with mild to moderate ischaemic syndromes have an increased risk of tobacco-related cancers, while those undergoing revascularization do not, possibly due to reduced angiogenesis or lifestyle changes.
Answers are grounded in this paper and cite their sources.
Mild-moderate ischaemic syndromes associate with higher cancer risk; hypothesis-generating and should not yet change surveillance practice.
INTRODUCTION: Angiogenesis constitutes the regulation of collateral formation in subjects with ischaemic syndromes and is also a prerequisite for cancer progression. Patients with severe symptomatic ischaemic syndromes may have a reduced ability for angiogenesis and thus a lower risk to develop cancer. SUBJECTS AND METHODS: Patients below 80 years and treated for acute myocardial infarction (AMI), angina pectoris (AP), intermittent claudication (IC) or undergoing revascularization during 1972-1991 in Stockholm county (n=63 921) were followed regarding cancer incidence 1972-2000. Cancer incidence was compared with that of the general population of Stockholm County by standardized incidence ratios (SIR). RESULTS: An increased incidence of cancer overall compared with the general population was seen in patients treated for AMI [SIR men 1.08 (95% Confidence Interval 1.04-1.11) and women 1.15 (1.09-1.21)], AP [men 1.16 (1.11-1.21) and women 1.06 (1.00-1.12)] and IC [men 1.48 (1.31-1.64) and women 1.43 (1.17-1.68)]. This increase was mainly due to an increased incidence of tobacco-related cancer. In patients undergoing revascularization no increase in incidence was seen [SIR men 0.97 (0.91-1.03) and women 1.06 (0.91-1.20)]. CONCLUSION: Patients with mild to moderate symptomatic ischaemic syndromes are, as expected, at increased risk of subsequently develop tobacco-related cancer. A lack of increased cancer risk in patients undergoing revascularization could be due to a reduced ability for angiogenesis in patients with severe atherosclerotic disease but may also be related to lifestyle changes.
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PEHRSSON et al. (2005) conducted a cohort in Ischaemic syndromes (n=63,921). Ischaemic syndromes vs. General population was evaluated on Cancer incidence (SIR 1.08, 95% CI 1.04-1.11). Patients with mild to moderate ischaemic syndromes (AMI, AP, IC) had an increased risk of cancer (e.g., AMI men SIR 1.08; 95% CI 1.04-1.11), whereas those undergoing revascularization did not.
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