Coronary microvascular dysfunction predicts cancer risk in NOCAD patients: Study
USA: Coronary microvascular dysfunction (CMD) in patients with non-obstructive coronary artery diseases (NOCAD) is linked with cancer incidence, says a recent study in the European Journal of Preventive Cardiology.
NOCAD is a less common form of coronary artery disease (CAD) that occurs when the heart's arteries are inappropriately constricted, are squeezed by the overlying heart muscle, or malfunction after branching into tiny vessels.
Previous studies have shown common pathogenesis and risk factors in cardiovascular disease and cancer. Coronary microvascular dysfunction indicating impaired coronary microvascular dilation in response to stress is tied to a higher risk of major cardiovascular events; however, no studies have been performed on establishing its association with cancer.
Considering the above, Amir Lerman, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA, and colleagues performed a retrospective study on 1042 patients with non-obstructive coronary artery diseases. They collected data on clinical history, demographic, cancer occurrence, and diagnostic coronary reactivity tests. CMD was defined as coronary flow reserve (CFR, the ratio of hyperemic blood flow to resting blood flow) ≤2.5.
Based on the study, the researchers found the following:
- Thirty-four percent had CMD (67.4% female and the average age was 52.4 ± 12.2 years).
- Of 917 patients with no history of cancer, 15.5% developed cancer during follow-up (median of 9 years).
- Kaplan-Meier analysis showed CMD patients had lower cancer-free survival compared to those without CMD.
- Cox proportional hazard analyses showed that after adjusting for age, sex, hypertension, diabetes, smoking, and glomerular filtration rate, CMD is independently associated with cancer (HR, 1.4).
- The rate of MACE was significantly higher in CMD compared to those non-CMD patients in patients who had a previous history of cancer (OR, 2.5) and patients with no history of cancer (OR, 1.4).
The authors conclude, "in patients presenting with non-obstructive coronary artery diseases, CMD is associated with cancer incidence. The study stresses following up in patients with CMD to evaluate MACE risk as well as potential malignant diseases."
Reference:
Nazanin Rajai, MD, MPH, Ali Ahmad, MD, Takumi Toya, MD, Jaskanwal D Sara, MD, Joerg Herrmann, MD, Lilach O Lerman, MD, PhD, Amir Lerman, MD, Coronary microvascular dysfunction is an independent predictor of developing cancer in patients with non-obstructive coronary artery disease (NOCAD), European Journal of Preventive Cardiology, 2022;, zwac184, https://doi.org/10.1093/eurjpc/zwac184
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