Risk Prediction Score for Cancer Development in Patients With Acute Coronary Syndrome

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  • Ishii Masanobu
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Marume Kyohei
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Nakai Michikazu
    National Cerebral and Cardiovascular Center
  • Ogata Soshiro
    National Cerebral and Cardiovascular Center
  • Kaichi Ryota
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Ikebe Sou
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Mori Takayuki
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Komaki Soichi
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Kusaka Hiroaki
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Toida Reiko
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Kurogi Kazumasa
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Ogawa Hisao
    National Cerebral and Cardiovascular Center
  • Iwanaga Yoshitaka
    National Cerebral and Cardiovascular Center
  • Miyamoto Yoshihiro
    National Cerebral and Cardiovascular Center
  • Yamamoto Nobuyasu
    Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital
  • Tsujita Kenichi
    Department of Cardiovascular Medicine, Kumamoto University Hospital

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<p>Background:Cancer is a known prognostic factor in patients with acute coronary syndrome (ACS), but few risk assessments of cancer development after ACS have been established.</p><p>Methods and Results:Of the 573 consecutive ACS admissions between January 2015 and March 2018 in Nobeoka City, Japan, 552 were analyzed. Prevalent cancer was defined as a treatment history of cancer, and incident cancer as post-discharge cancer incidence. The primary endpoint was post-discharge cancer incidence, and the secondary endpoint was all-cause death during follow-up. All-cause death occurred in 9 (23.1%) patients with prevalent cancer, and in 17 (3.5%) without cancer. In the multivariable analysis, prevalent cancer was associated with all-cause death. To develop the prediction model for cancer incidence, 21 patients with incident cancer and 492 without cancer were analyzed. We compared the performance of D-dimer with that of the prediction model, which added age (≥65 years), smoking history, and high red blood cell distribution width to albumin ratio (RAR) to D-dimer. The areas under the receiver-operating characteristics curves of D-dimer and the prediction model were 0.619 (95% confidence interval: 0.512–0.725) and 0.774 (0.676–0.873), respectively. Decision curve analysis showed superior net benefits of the prediction model.</p><p>Conclusions:By adding elderly, smoking, and high RAR to D-dimer to the prediction model it became clinically useful for predicting cancer incidence after ACS.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 88 (2), 234-242, 2024-01-25

    一般社団法人 日本循環器学会

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