Invasive vs. Conservative Management in Cancer Patients With Non-ST Elevation MI (CAN-NSTEMI)"

Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Status: Completed

Conditions: Myocardial Infarction

Treatments: Other: Observational Study

Study type: Observational

Funder types: Other

Identifiers

NCT06702436

NONST_MI_ONCOLOGY

Details and patient eligibility

About

This retrospective study investigates the impact of invasive versus conservative management strategies in cancer patients presenting with non-ST elevation myocardial infarction (non-ST MI). Patients aged 18 and older, who were treated for non-ST MI in a hospital setting and had a confirmed cancer diagnosis, are included. The primary outcome is hospital mortality, assessed using GRACE scores to evaluate mortality risk. Patients are grouped based on their received interventions-either invasive (including coronary angiography and revascularization) or pharmacological treatment. Risk factors contributing to mortality, such as cancer type, metastasis presence, comorbidities, and laboratory findings, will also be analyzed to better understand the interplay of oncologic and cardiovascular conditions in this population.

Enrollment: 12,500 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: Patients aged 18 years and older.
• Diagnosis: Patients with a confirmed cancer diagnosis.
• Acute Condition: Patients diagnosed with non-ST elevation myocardial infarction (non-ST MI).
• Treatment: Patients who received either invasive treatment (including coronary angiography and revascularization) or conservative (pharmacological) treatment for non-ST MI.
• Consent: Patients who have provided informed consent or are part of a retrospective study where consent is waived.

Exclusion criteria

• Age: Patients younger than 18 years.
• Non-cancer diagnoses: Patients without a cancer diagnosis.
• ST-Elevation Myocardial Infarction: Patients with ST elevation myocardial infarction (STEMI) instead of non-ST elevation myocardial infarction (NSTEMI).
• Pre-existing severe comorbidities: Patients with severe or terminal comorbidities (e.g., end-stage liver disease, end-stage renal disease, or severe cognitive impairment) that would confound the outcomes.
• Incomplete medical records: Patients with missing data on relevant clinical variables (e.g., GRACE score, treatment received, or mortality data).
• Pregnancy: Pregnant patients, as their conditions may complicate the interpretation of results.
• Inability to provide informed consent: Patients unable to provide informed consent (if applicable).

Trial design

12,500 participants in 2 patient groups

Invasive Treatment Group

Description:

The Invasive Treatment Group will include cancer patients aged 18 and older diagnosed with non-ST elevation myocardial infarction (NSTEMI) who received an invasive treatment approach. This group will consist of patients who underwent coronary angiography followed by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). These patients may have various cancer types, with no restriction on the diagnosis, but must have been treated with invasive procedures for NSTEMI during their hospitalization. The cohort will be assessed for mortality, re-hospitalization rates, and cardiovascular events. The study will also evaluate factors such as cancer stage, metastasis, and comorbidities to understand the outcomes of invasive treatment in this population.

Treatment:

Other: Observational Study

Conservative Treatment Group

Description:

The Conservative Treatment Group will include cancer patients aged 18 and older diagnosed with NSTEMI and managed with medical treatment alone. This group will consist of patients who received pharmacological management (antiplatelet therapy, anticoagulants, beta-blockers, statins) without coronary angiography or revascularization. These patients may have different cancer types, and the study will focus on those treated conservatively during their hospital stay. Mortality, re-hospitalization, and cardiovascular events will be assessed. The analysis will also consider cancer type, disease stage, comorbidities, and pharmacological therapy's impact on long-term outcomes.

Treatment:

Other: Observational Study