부산대학교 도서관

Background: Women with breast cancer (BC) have a higher risk for cardiovascular (CV) disease. Data regarding the risk factor profiles and outcomes of first acute myocardial infarction (AMI) in women with BC compared to those without BC are limited. Methods: We queried the US National Inpatient Sample years 2005-2015 using appropriate ICD-9 codes to obtain a weighted sample of adult female patients hospitalized for first AMI. In this cohort, patients with BC were identified. We compared baseline demographics, comorbidities, and outcomes in women with and without BC using survey specific descriptive analytic tests. Multivariable logistic regression was used to identify the association of BC with in-hospital mortality after adjusting for AMI type, patient and hospital characteristics, comorbidities, complications, and revascularization status (c-statistic 0.82). Results: Of 1,809,107 first AMI cases in adult women, BC was present in 69,743 (3.9%). At the time of a first AMI, women with BC were 6 years older than those without (mean age 77 vs 71 years, p<.001) and had a higher mean Elixhauser comorbidity burden (2.8 vs 2.6, p<0.001). Compared to woman without BC, women with BC had higher prevalence of dyslipidemia (52% vs 48%) and hypertension (73% vs 68%), and lower prevalence of obesity (9% vs 13%), diabetes mellitus (31% vs 34%), and smoking (24% vs 27%) (p<.001 for all). Women with BC were more likely to have a non-ST segment elevation MI (72.5% vs 69%), and less likely to receive percutaneous coronary intervention (32.8% vs 36.5%), coronary artery bypass grafting (5.2% vs 7.0%), or any revascularization (37.7% vs 42.8%) compared to those without BC (p<.001 for all comparisons). In-hospital mortality was lower in women with BC (6.8%) compared to those without (7.3%, p=0.041), findings which persisted after risk adjustment (OR for BC: 0.88, 95% CI 0.82-0.94). After age stratification, lower risk adjusted mortality was only seen in women > 55 years. Conclusions: In the US, women with BC had a first AMI at an older age and had small but significant differences in CV risk factors and outcomes compared to women without BC. The possibility that personal lifestyle choices and better-quality medical care in women with BC contribute to these differences should be explored. [ABSTRACT FROM AUTHOR]