# Comparison of Diagnostic Parameters of Acute Coronary Syndromes in Patients with and without Cancer: A Multifactorial Analysis

## TL;DR

This study compares how heart attacks present differently in cancer patients versus non-cancer patients, showing cancer patients often have less chest pain and more hypotension.

## Contribution

The study identifies distinct clinical features of acute coronary syndromes in patients with concurrent cancer, emphasizing the need for tailored diagnostic approaches.

## Key findings

- Cancer patients with ACS were older and had more chronic kidney disease but less hyperlipidemia.
- Cancer patients presented with less chest pain and more hypotension compared to non-cancer patients.
- Cancer patients had a higher rate of NSTEMI and lower rates of STEMI and specific coronary artery involvement.

## Abstract

Background: The simultaneous occurrence of cancer and acute coronary syndromes (ACSs) presents a complex clinical challenge. This study clarifies variances in diagnostic parameters among ACS patients with and without concurrent cancer. Methods: This retrospective study included 320 individuals diagnosed with ACS, stratified equally into two cohorts—one with cancer and the other cancer-free. We evaluated risk factors, symptom profiles, coronary angiography results, echocardiographic evaluations, and laboratory diagnostics. Statistical analysis was performed using Student’s t-test, the Mann–Whitney U test, and the chi-square test. Results: Cancer patients were older (mean age 71.03 vs. 65.13 years, p < 0.001) and had a higher prevalence of chronic kidney disease (33.1% vs. 15.0%, p < 0.001) but a lower prevalence of hyperlipidemia (59.7% vs. 82.5%, p < 0.001). Chest pain was less frequent in cancer patients (72.5% vs. 90%, p < 0.001), while hypotension was more common (41.9% vs. 28.8%, p = 0.022). NSTEMI was more common in cancer patients (41.9% vs. 30.6%, p = 0.048), while STEMI was less common (20.6% vs. 45.3%, p < 0.001). RCA and LAD involvement were less frequent in cancer patients (RCA: 18.1% vs. 30.0%, p = 0.018; LAD: 18.8% vs. 30.0%, p = 0.026). Conclusions: This study demonstrates differences in the clinical presentation of ACS between patients with and without cancer. Cancer patients were less likely to present with chest pain and more likely to experience hypotension. Additionally, they had a higher prevalence of chronic kidney disease and they were less likely to have hyperlipidemia. These findings highlight the need for a careful approach to diagnosing ACS in oncology patients, considering their distinct symptomatology.