Nationwide population-based cohort study on the association of acute coronary syndrome in patients with malignancies

Aims/introduction: Patients with malignancy are suggestive of having a tendency toward an association with vascular thrombosis risk. The aim of this study was to evaluate the possible relationship between malignancy and the risk of acute coronary syndrome (ACS) in Taiwan.

Materials and methods: We used data from the National Health Insurance (NHI) system of Taiwan to assess the issue. Cox proportional hazards regression analysis was conducted to estimate the effects of malignancy on the risk of ACS.

Results: ACS risk in patients with malignancies was marginally significantly greater when adjusted for age, sex (hazard ratio (HR) = 1.09, 95 % confidence interval (CI) = 0.99–1.20), and comorbidities (HR = 1.03, 95 % CI = 0.93–1.13). A subgroup analysis indicated that patients with prostate cancer and head and neck cancer (HEENT) had a significantly higher risk of ACS (HR = 1.30, 95 % CI = 1.01–1.67; HR = 3.03, 95 % CI = 1.47–6.50).

Conclusions: We suggest careful surveillance of ACS symptoms and regular electrocardiography during follow-up of these patients. However, further large-scale studies for patients with prostate and HEENT cancer and cancer survivors (especially from post-hormone or radiotherapy) are needed.