In-hospital outcomes of acute coronary syndrome in patients with cancer: A systematic review and meta-analysis

Document Type

Review Article

Department

Medicine

Abstract

Background: Patients with a history of malignancy are at elevated risk for acute coronary syndrome (ACS). This study evaluates in-hospital cardiovascular outcomes in ACS patients with and without a cancer history.
Methods: A systematic search of PubMed, Scopus, Embase, and ClinicalTrials.gov (2000-2025) identified studies comparing in-hospital outcomes for ACS in patients with vs. without malignancy. Data were pooled and analyzed using RevMan 5.4, calculating risk ratios (RRs) under a random-effects model.
Results: Fifteen studies were included. Among ACS patients, a history of cancer was associated with significantly worse in-hospital outcomes. Cancer history increased all-cause mortality by 44% [RR: 1.44; 95% confidence interval (CI): 1.21-1.71; P < 0.001], bleeding by 72% (RR: 1.72; 95% CI: 1.33-2.22; P < 0.001), major adverse cardiac events (MACE) by 18% (RR: 1.18; 95% CI: 1.17-1.19; P < 0.001), and stroke by 48% (RR: 1.48; 95% CI: 1.35-1.63; P < 0.001). No significant associations were observed for heart failure (RR: 1.24; 95% CI: 0.96-1.59; P = 0.10), re-infarction (RR: 1.17; 95% CI: 0.83-1.65; P = 0.36), or cardiogenic shock (RR: 1.22; 95% CI: 0.97-1.55; P = 0.09).
Conclusion: Patients with a history of malignancy presenting with ACS face significantly higher in-hospital risks of mortality, bleeding, MACE, and stroke, while risks of heart failure, re-infarction, and shock show nonsignificant trends. These findings underscore the vulnerability of this population and highlight the need for multidisciplinary, individualized management strategies to improve outcomes.

Publication (Name of Journal)

Journal of Cardiovascular Medicine Navbar

DOI

10.2459/JCM.0000000000001894

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