The impact of prostate cancer on outcomes of patients hospitalized with acute myocardial injury: A national representative sample.

Abstract

e17165 Background: Prostate cancer has seen improved survival rates due to advancements in diagnosis and treatment. However, these gains have come with new challenges, as therapies such as androgen deprivation therapy (ADT) are associated with increased cardiovascular risks. Additionally, prostate cancer and cardiovascular diseases have overlapping risk factors such as age, metabolic syndrome, and chronic inflammation. Despite the clinical significance of this interplay, the impact of prostate cancer on patients with acute myocardial infarction (AMI) remains understudied. Methods: ICD-10 codes were used to identify AMI hospitalizations in the National Inpatient Sample (2016-2020). The study population, aged >18 years, was divided into prostate cancer and no prostate cancer. Survey-weighted linear regression was done to adjust for baseline characteristics, co-morbidities, and sample sizes. Outcomes were compared using descriptive statistics, T-test, and Chi-square test. Statistical significance was set at 0.05. Results: A total of 582,294 patients with AMI were identified, of which 29,697 (5.1%,) had prostate cancer. Patients with PC were associated with a higher mortality rate (8.6% vs. 4.9%, p<0.001), longer lengths of stay (4.79 days vs. 4.39 days, p<0.001), and higher total hospitalization charges ($118,996 vs. $112,059, p=0.029). After adjusting for confounders, PC remained independently associated with a higher risk of mortality (adjusted OR 1.18, 95% CI [1.06-1.36], p=0.002). Conclusions: Prostate cancer patients with AMI have significantly worse in-hospital outcomes. These findings underscore the necessity to integrate routine cardiovascular screening and risk mitigation strategies for prostate cancer patients, especially those on ADT, as well as a closer collaboration between oncology and cardiology teams when managing these patients. Further research is necessary to better elucidate the mechanisms driving these adverse outcomes and develop targeted interventions that will optimize cardiovascular and oncology outcomes in this high-risk patient population. In-hospital outcomes. Variable Value AMI patients (total) 582,294 Prostate cancer patients (%) 5.10% Mortality rate in prostate cancer patients (%) 8.60% Mortality rate in non prostate cancer patients (%) 4.90% Odds ratio for mortality in prostate cancer patients 1.81 (95% CI 1.35-2.41, p<0.001) Length of stay in prostate cancer patients (days) 4.79 Length of stay in non prostate cancer patients (days) 4.39 Total hospitalization charges in prostate cancer patients ($) $112,059 Total hospitalization charges in non prostate cancer patients ($) $118,996 Adjusted odds ratio for mortality (p-value) 1.18 (95% CI 1.06-1.36, p=0.002) Adjusted length of stay (p-value) 1.38 days (p<0.001) Adjusted total hospitalization charges (p-value) $32,810 (p<0.001)