Abstract 17681: Stress Cardiomyopathy Developed in Patients With Cancer: Clinical Characteristics and Outcomes
Introduction: Sporadic case reports have shown that stress cardiomyopathy (SCM) can happen during treatment of underlying malignancy. However, clinical association between cancer and SCM needs further investigation.
Methods: Echocardiographic data base from Jan 2009 to June 2014 was used to identify SCM patients in whom clinical and imaging data information was used to rule out classic myocardial infarction. Clinical characteristics, underlying comorbidities, and outcomes including in-hospital mortality were explored.
Results: We retrospectively identified 549 consecutive patients (age, 64±15 years; 328 female) with SCMP in a single tertiary referral hospital. Among them, 210 patients had an active history of cancer (group 1, 38%), whereas the resting 339 did not (group 2). Hematologic malignancy including leukemia, lymphoma and multiple myeloma was the most common (n=44, 21.0%), followed by lung (n=39, 18.6%), stomach (7.6%), ovary (6.2%), and colorectal cancer (5.7%). Group 1 was characterized by younger age (62±13 vs. 65±16 years, p=0.002) with lower frequency of coronary risk factors, lower prevalence of female gender (54±63%, p=0.04), and lower frequency of underlying comorbidities including renal failure, stroke and heart failure. Physical illness associated with underlying medical conditions such as sepsis was the most common triggering event (79%), followed by routine surgery or procedure (18%); SCM triggered by emotional stress is very rare (<5%). Typical apical ballooning was present in 70% with atypical apical-sparing ballooning in 30% and this pattern did not show any difference between two groups. Left ventricular ejection fraction was lower in group 1 with higher prevalence of right ventricular ballooning, pulmonary hypertension and pericardial effusion. Hospital mortality was higher in group 1 (29% vs 20%, p=0.017) and active history of cancer was an independent factor associated with hospital mortality (odds ratio 1.60, 95% CI 1.063 - 2.410, p = 0.024). SCM development was not associated with history and timing of chemotherapy, which did not affect hospital mortality either.
Conclusions: Cancer is an important risk factor of SCM development in a tertiary referral hospital and should be considered a poor prognostic factor.
Author Disclosures: Y. Jeong: None. J. Kim: None. J. Park: None. C. Lee: None. M. Cho: None. J. Bae: None. Y. Kim: None. P. Lee: None. J. Jang: None. S. Lee: None. D. Kim: None. J. Song: None. K. Choi: None. D. Kang: None. J. Song: None.
- © 2015 by American Heart Association, Inc.