Key result
Cancer is linked to ~2.5-fold higher cardiovascular death compared to non-cancer controls.
Why the study?
Although cancer and acute MI often coexist, the incidence of MI in patients with cancer and the prognostic impact of revascularization versus medical treatment for MI in these patients remained unclear.
Does revascularization reduce cardiovascular death compared with medical treatment alone in patients with cancer who develop acute myocardial infarction?
Cohort (n=1,364,060)
Yes
Does revascularization reduce cardiovascular death compared with medical treatment alone in patients with cancer who develop acute myocardial infarction?
In a large nationwide Korean cohort, patients with cancer experienced a 2.5-fold higher risk of cardiovascular death than matched controls despite a slightly lower overall incidence of acute MI, and those who developed MI derived a significant survival benefit from revascularization over medical therapy alone.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
““These findings indicate a possible health care disparity that acute MI in patients with cancer is systematically underdiagnosed and undertreated in routine clinical practice,” said Seung Hun Lee, MD, PhD, FACC, et al.”
Cancer associated with higher CV death; extends evidence to large Asian cohort but leaves open causal pathways and interventions.
Background Although cancer and acute myocardial infarction (MI) often coexist, the prognostic impact of revascularization for MI in patients with cancer remains unclear. Objectives The authors aim to evaluate the incidence of MI among patients with cancer and the prognostic impact of revascularization for MI in patients with cancer compared with medical treatment. Methods A retrospective, nationwide, cohort study was conducted using the Korean National Health Insurance Service database. A total of 682,030 patients newly diagnosed with cancer from 2016 to 2018 and 682,030 propensity score-matched individuals without cancer were included. The primary outcome was cardiovascular death. The median follow-up was 6 years. Results The incidence rates of cardiovascular death were 1,692.4 (95% CI: 1,678.3-1,706.5) per 100,000 person-years in patients with cancer and 796.3 (95% CI: 788.2-804.5) in controls (HR adj : 2.50; 95% CI: 2.47-2.54; P < 0.001). The incidence rates of MI were 156.5 (95% CI: 152.2-160.9) and 191.7 (95% CI: 187.7-195.8) per 100,000 person-years, respectively (HR adj : 0.93; 95% CI: 0.90-0.96; P < 0.001). Cardiovascular outcomes varied across cancer types. Pancreatic, hepatic, lung, and hematologic malignancies were associated with the highest risks of cardiovascular death, whereas an increased risk of acute MI was observed in lung cancer and hematologic malignancy. Among patients with cancer who developed MI, revascularization was associated with lower cardiovascular death than medical treatment alone (HR adj : 0.82; 95% CI: 0.73-0.92; P < 0.001). Conclusions Although patients with cancer had a higher risk of cardiovascular death than the general population, the observed incidence rate of MI was lower. Even among patients with cancer, revascularization for MI was associated with a lower risk of cardiovascular death than medical treatment alone.
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Lee et al. (2026) conducted a cohort in Cancer and acute myocardial infarction (n=1,364,060). Newly diagnosed cancer (and revascularization in the MI subgroup) vs. Matched individuals without cancer (and medical treatment alone in the MI subgroup) was evaluated on Cardiovascular death (HR 2.50, 95% CI 2.47-2.54, p=<0.001). Cancer increased cardiovascular death vs non-cancer controls (HR 2.50; 95% CI 2.47-2.54), and revascularization for MI in cancer patients lowered CV death vs medical therapy (HR 0.82; P<0.001).
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