Background and Objective:
Coronary artery disease (CAD) and cancer are the leading causes of death worldwide and share some risk factors, such as aging and smoking. Concurrence of CAD and cancers makes diagnosis and treatment more clinical challenging. In patients who need stent implantation followed by dual antiplatelet therapy, fatal perioperative complications such as bleeding and stent thrombosis may occur. There is no data regarding the prevalence and risk factors of cancer in patients with CAD. This study investigated the cancer prevalence and risk factors in patients with newly diagnosed CAD.
Methods and Results:
Three thousand and one hundred and eighty six consecutive patients with newly angiographically documented CAD were prospectively enrolled between January 2009 and March 2015. Serum levels of tumor markers, including carcinoembryonic antigen, alpha fetoprotein, carbohydrate antigen125, carbohydrate antigen 153, carbohydrate antigen199, squamous cell cancer antigen, and prostate-specific antigen, were measured. Diagnosis of cancer was confirmed by pathology or imaging with ultrasound, computed tomography or magnetic resonance. The prevalence of cancer in CAD patients was 1.1% (35 out of 3186), involving the in gastroenterogical, respiratory, endocrine and exocrine, urinary and hematopoietic systems. Among these cancer patients, 17 patients had stent implantation, with 7 AMI patients undergoing emergency PCI. Multivariate analysis revealed that, in addition to male gender and advanced age, lower plasma low-density lipoprotein (LDL) cholesterol levels were independently associated with the occurrence of cancer in CAD patients (P<0.01).
Conclusion:
Cancers occur in 1.1% of patients with CAD. Low LDL levels may increase the risk for cancers in the CAD patients. Further large scale studies are needed to validate this association.
Coronary Artery Disease Detected by Coronary Computed Tomographic Angiography Is Associated With Intensification of Preventive Medical Therapy and Lower Low-Density Lipoprotein Cholesterol
