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Evidence is mounting that individuals with active or past history of cancer are at increased risk for acute cardiovascular events such as as acute myocardial infarction. This secondary analysis from the APACE (Advantageous Predictors of Acute Coronary Syndromes Evaluation) study- a multicenter, international, prospective diagnostic study looked at the prevalence of MI in patients with history of cancer presenting to the ED with acute chest pain, diagnostic accuracy of high-sensitivity troponins and diagnostic algorithms (European Society of Cardiology algorithm- see paper for details), among a few other parameters.
Take home points:
- There was substantially higher prevalence of AMI in patients with cancer.
- The diagnostic performance of the high-sensitivity troponin algorithms was reduced.
Translation to practice:
Be more conservative with cancer patients presenting to the ED with acute chest pain!
References
Bima, P, Lopez-Ayala, P, Koechlin, L. et al. Chest Pain in Cancer Patients: Prevalence of Myocardial Infarction and Performance of High-Sensitivity Cardiac Troponins. J Am Coll Cardiol CardioOnc. 2023 Oct, 5 (5) 591–609.
https://doi.org/10.1016/j.jaccao.2023.08.001