Impact of cardio-oncology services on care and outcomes of STEMI patients with active cancer

We assessed the impact of cardio-oncology services on care and outcomes of patients with cancer presenting with STEMI

A nationally linked cohort of STEMI patients was obtained from the MINAP and UK national Hospital Episode Statistics Admitted Patient Care (HES APC) registries. We used multivariable logistic regression models, with mixed effect survival analysis, and competing risk models to assess the association between the availability of cardio-oncology services and the in-hospital outcomes, all-cause death, and post-discharge outcomes (bleeding, reinfarction, and cardiovascular death) respectively.

A total of 4,981 STEMI indexed admissions with cancer were identified between 1st Jan 2012 and 30th March 2019. Of those, 329 (6.6%) patients were admitted to cardio-oncology centers. Patients admitted to cardio-oncology centers were more likely to receive PCI (89.4% vs 70.9%) and DAPT (90.9% vs 83.6%). They had higher odds of receiving optimal inpatient care (OR 2.1, 95% CI 1.2-3.6). After adjusting for comorbidities, the risk of all-cause death (HR 0.9, 95% CI 0.7-1.4), cardiovascular death (SHR 0.8, 95% CI 0.3-1.3%), bleeding (SHR 1.0, 95% CI 0.6-1.5), and reinfarction (SHR 0.7, 95% CI 0.4-1.3) at 1 year were comparable between the two groups.

The presence of cardio-oncology services improves quality of care in patients admitted with STEMI. More efforts are required to improve patients survival.