Introduction
To keep our readers up to date with the latest research in the exponentially growing field of cardio-oncology, we have compiled summaries of relevant abstracts presented at the European Society of Cardiology Congress 2019. Our hope is to educate but also promote interest and the formation of new collaborations. Abstracts are categorized as follows:

1. Cardiovascular Imaging
2. Biomarkers
3. AF and Other Arrhythmias
4. Breast Cancer
5. Other Outcomes
6. ACS, PCI, Transcathether Aortic Valve Replacements, and Other Procedures

Our hope is that this serves as a good reference for new research coming out, and, if you're interested in one of these topics, leads you to do further reading.

I. Cardiovascular Imaging

I.A. The clinical value of CMR in the management of Cardio-Oncology patients - a tertiary center experience
By Jun Hua Chong

• The authors evaluated the ability of cardiac magnetic resonance imaging (cMRI) to provide additive value in the context of cardio-oncology. They reviewed 102 cMRI ordered in 92 patients with cancer. Most were ordered to confirm an echocardiographic decrease in ejection fraction. cMRI findings had a clinical impact in 61% of patients and assisted in adjudicating a new diagnosis in 29% of patients. Of the total number of patients, 88% were able to continue anthracycline/anti-HER2 therapies based on cMRI findings of stable left ventricular ejection fraction (LVEF).

I.B. Cardiac strain detects subclinical decline of cardiac function after hematopoietic stem cell transplantation in patients with hematologic malignancies
ByMakiko Oboshi

• This study retrospectively analyzed global longitudinal strain (GLS) and cardiac parameters in 31 patients with hematologic malignancies before and after hematopoietic stem cell transplantation (HSCT). The authors report a slight increase in troponin levels (0.010 ± 0.002 ng/ml to 0.016 ± 0.014 ng/ml) and minor decrease in absolute GLS (19.4 ± 0.8 % to 18.8 ± 0.8 %), which were not correlated.

I.C. Impacts of echocardiography-defined pulmonary hypertension on clinical outcome in patients with multiple myeloma
By Bae Sunga

• This study investigates the risk factors of transthoracic echocardiography-defined pulmonary hypertension and its association with mortality in 277 patients with multiple myeloma (MM). They report that pulmonary hypertension, congestive heart failure (CHF), and diabetes mellitus are independently associated with all-cause death in MM patients.

I.D. 3D echocardiography, arterial stiffness, and biomarkers for detection and prediction of late cardiotoxicity in non-Hodgkin lymphoma
By Diana Mihalcea

• This study aimed to define new parameters to detect late cardiotoxicity in patients with non-Hodgkin lymphoma (NHL) treated with CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone). Among 64 patients with NHL scheduled for CHOP, longitudinal strain reduction after chemotherapy ended was the best independent predictor for LVEF decrease 1 year after therapy completion (R² = 0.42; p = 0.001).

I.E. Behavior of 2D and 3D derived ejection fraction and strain in patients with Hodgkin and non-Hodgkin lymphoma undergoing anthracycline-based chemotherapy, a prospective study
By Temilolaoluwa Daramola

• This study evaluated 130 patients with Hodgkin lymphoma or NHL of which 12% developed cancer therapy-related cardiac dysfunction. The strongest predictors of cancer therapy-related cardiac dysfunction were three-dimensional GLS and circumferential strain either individually or combined at the completion of chemotherapy.

I.F. Cardiac dysfunction as a predictor of hepatic sinusoidal obstruction syndrome after hematopoietic cell transplantation
By Kye Hun Kim

• Among 92 patients treated with hematopoietic cell transplantation, 11 developed Hepatic sinusoidal obstruction syndrome. Left ventricular (LV) end-diastolic volume index was the most powerful predictor for Hepatic sinusoidal obstruction syndrome, and the optimal cutoff value was 59.25 mL/m2 (81.8% sensitivity and 77.8% specificity, area under the curve = 0.909).

I.G. Clinical and echocardiographic characteristics in patients with pathology proven cardiac papillary fibroelastomas
By Reto Daniel Kurmann

• Among 62 patients with pathology-proven papillary fibroelastoma, most were located on the aortic valve (73%) followed by the mitral valve (16%). Valvular papillary fibroelastoma was associated with significant functional valve abnormality in 15% of patients, and the abnormality was attributed to the papillary fibroelastoma in 9% of patients. Of the total number of patients, 40% had a documented stroke/transient ischemic attack prior to papillary fibroelastoma.

I.H. Severity of lymphoma is associated with aortic FDG uptake assessed by FDG PET/CT imaging
By Eirini Solomou

• The authors assessed aortic inflammation measured by arterial F-18 fluorodeoxyglucose uptake on positron emission tomography in 62 patients with lymphoma (n = 29 with Hodgkin lymphoma). Disease severity was quantified by total metabolic tumor volume, and aortic fluorodeoxyglucose uptake assessment was based on target-to-background ratio. Aortic target-to-background ratio uptake and total metabolic tumor volume were significantly associated even after adjustment for age, sex, lactate dehydrogenase, and albumin, as well as for the number of cardiovascular risk factors of each patient.

I.I. Clinical utility of echocardiographic left-ventricular ejection fraction monitoring for cardiotoxicity risk assessment in patients with HER2+ early breast cancer undergoing trastuzumab-based therapy
By Peter Rainer

• The authors assessed the prognostic impact of LVEF and its change over time in 185 women with HER2+ early breast cancer treated with trastuzumab (total of 1,136 echocardiography reports). Nineteen patients (10%) experienced cardiotoxicity (10% decrease in LVEF below 50%). One-year cardiotoxicity risk was 7.6% in the 35 patients with a baseline LVEF = 60% and 24.5% in the 150 patients with a baseline LVEF <60% (hazard ratio [HR] 3.45; 95% confidence interval [CI], 1.35-8.75). During treatment, LVEF declined significantly faster in patients who developed cardiotoxicity than in patients without cardiotoxicity (1.3% per month vs. 0.1% per month). A higher rate of LVEF decrease predicted for higher cardiotoxicity risk (HR per 0.1% per month higher LVEF decrease per month = 2.50; 95% CI, 1.31-4.76).

I.J. Predictors of progression of preclinical left ventricular diastolic dysfunction to clinical heart failure in patients with malignancy
By Safeera Javed

• The authors assessed the incidence of CHF in patients with cancer with preexisting preclinical diastolic dysfunction (grade 1). Out of 1,086 patients with malignancy and diastolic dysfunction, 208 were diagnosed with new onset CHF during the 10 years follow-up. Incidence of CHF, heart failure with preserved ejection fraction, and heart failure with reduced ejection fraction was found to be 32.1 per 1,000 person-year, 13.9 per 1,000 person-year, and 2.93 per 1,000 person-year, respectively, with a significantly high incidence of heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction (8.3% vs. 1.75%). Vincristine, ifosfamide, trastuzumab, and bortezomib were found to be associated with incident CHF.

I.K. Left ventricular systolic function in long term survivors of allogeneic hematopoietic stem cell transplantation
By Richard Massey

• The authors characterized LV function in 104 survivors of allogeneic HSCT (mean age 18) and compared with healthy controls matched for age, gender, and body mass index. Most parameters of LV systolic function including ejection fraction, GLS, mitral annulus excursion, and s' were all significantly impaired after allogeneic HSCT compared with the control group, with pre-transplantation anthracycline dose and graft versus host disease significantly associated with increased risk of cardiotoxicity.

II. Biomarkers

II.A. Cardiac biomarkers for the prediction of cardiotoxicity in cancer patients: a meta-analysis
By Lars Michel

• This meta-analysis of 58 studies assessed cardiac troponin and brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the prediction of LV systolic dysfunction in patients with cancer on anthracyclines or HER2 inhibitors. Increased troponin, but not BNP/NT-proBNP, was associated with a decrease in LVEF.

II.B. Cardiac biomarkers for the detection of anthracycline cardiotoxicity in childhood cancer - a meta-analysis
By Lars Michel

• This review of 27 studies among pediatric patients with cancer and survivors of childhood cancer showed that BNP/NT-proBNP levels were higher post-treatment compared with control subjects or pre-treatment values (standardized mean difference = 1.0; 95% CI, 0.6-1.4; n = 239). The risk for LV dysfunction was increased in patients with elevated BNP/NT-proBNP (odds ratio [OR] 5.5; 95% CI, 2.0-15.2; n = 357).

II.C. Cardiovascular and inflammatory biomarkers in cancer patients and their impact on mortality
By Laura-Carina Lueck

• The authors investigated the prognostic impact of biomarker levels in patients with cancer without significant cardiovascular disease at baseline. In 138 patients with cancer without significant cardiovascular disease, NT-proBNP, high-sensitive troponin T, and C-reactive protein were significantly increased compared with healthy controls and were associated with mortality.

III. AF and Other Arrhythmias

III.A. Atrial fibrillation is an independent predictor of mortality in hospitalized cancer patients
By Aaqib H Malik

• The authors performed a study to evaluate the outcomes associated with hospitalized patients with cancer with atrial fibrillation (AF), identifying 12,410,290 (nationwide estimate) patients with a cancer diagnosis, of which 8.2% had AF. AF was also found to be an independent risk factor for higher in-hospital mortality in patients with cancer (OR 1.25; 95% CI; 1.23, 1.28; p < 0.0001).

III.B. Predictors of mortality in hospitalized atrial fibrillation patients with cancer
By Aaqib H. Malik

• Among 12,410,290 (national estimate) patients with a cancer diagnosis, 1,013,735 had AF, and 10.2% of the patients with AF and cancer died while hospitalized. A variety of comorbidities, in-hospital procedures, and in-hospital complications increased the odds of in-hospital mortality in these patients. Weekend admissions, elective admissions, and rural hospitals in comparison to urban teaching and non-teaching hospitals were associated with higher in-hospital mortality.

III.C. Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices
By Jacopo Francesco Imberti

• The aim of this study was to estimate the prevalence and possible predictors of radiotherapy (RT) related cardiovascular implantable device malfunctions and to describe malfunction characteristics. Out of 127 patients, 81% of patients had a pacemaker, and 19% had an implantable cardiovascular defibrillator. Neutron-producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients, respectively. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event.

III.D. Current status of anticoagulation in patients with breast cancer and atrial fibrillation
By Ana Pardo Sanz

• The authors compared the embolic and bleeding risk, the preventive management, and the incidence of events between patients with and without cancer using the AMBER-AF registry (Antithrombotic Management of patients with Breast Cancer and Atrial Fibrillation multicenter registry) and the effectiveness of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs). Out of 1,237 female patients with AF (637 with breast cancer), adjusted rates of stroke (HR [95% CI]) in patients with cancer were higher (1.56 [1.04-2.35]) than patients without cancer, whereas bleeding rates remained similar (1.25 [0.95-1.64]). Within the group of patients with cancer, the use of DOACs versus VKAs was not associated with differences in the adjusted rates of stroke (0.91 [0.42-1.99]) or severe bleeding (1.53 [0.93-2.53]).

III.E. Impact of atrial fibrillation on 10y all-cause mortality in curatively treated breast cancer patients
By Johanna Jacobs

• The authors evaluated the incidence of AF and flutter among 805 curatively treated patients with breast cancer and assessed its impact on survival in an all-comer population at a tertiary care center. They found that AF or flutter was present in 70 (8.7%) patients over 10-year follow-up. Mortality amongst breast cancer survivors with AF or flutter was twice as high 44.3% (31/70) versus 21.9% (161/735) compared with those who remained in sinus rhythm.

III.F. Cisplatin therapy as a risk factor for incident atrial fibrillation
By Brandon Chalazan

• The authors sought to define the incidence and prevalence of AF in 3,336 patients with breast or lung cancer. Patients with AF, RT, or chemotherapy prior to cancer diagnosis were excluded. The AF incident rate for breast and lung cancer was 1.2 and 13.5 cases per every 100 persons and an overall AF prevalence of 3.4% and 7.4%, respectively. There was no association between RT and AF in either cancer type (breast: p = 0.18; lung: p = 0.16). Patients who received cisplatin had fourfold increased risk of developing AF.

III.G. Incidence of sinus node dysfunction with cancer chemotherapy: a systematic review of literature
By Navya Alugubelli

• The authors assessed the incidence of sinus-node dysfunction (including sinus bradycardia, sinus pauses, sinoatrial exit blocks or asystole) in patients receiving chemotherapy. Through a systematic review of the literature, they found that the incidence of sinus node dysfunction varied significantly between drug classes. Specific drugs were associated with increased incidence of sinus node dysfunction, like anthracyclines (epirubicin 8.3%), antimetabolites (5 Fluorouracil 20%), tyrosine kinase inhibitors (crizotinib 43%), antimicrotubule agents (paclitaxel 29%), and angiogenesis inhibitors (thalidomide 22%).

IV. Breast Cancer

IV.A. The Impact of a multi-disciplinary cardio-oncology program on the cardiovascular outcomes in breast cancer patients
By Chang Wei-Ting

• The authors evaluated and followed 154 patients with newly diagnosed breast cancer preparing for epirubicin therapy for 1 year. There was a significant improvement in screening with echocardiograms with the start of the cardio-oncology program and a reduction in outcomes including new onset hypertension (1.7% vs. 0.6%, before vs. after initiation of program, respectively), stroke (0.8% vs. 0%), myocardial infarction (MI) (0.8% vs. 0%), and mortality (16.8% vs. not reported).

IV.B. Chemotherapy-induced vasotoxicity in patients undergoing therapy for breast cancer
By Alexios Antonopoulos

• The authors used echocardiography, brachial flow mediated dilation, and carotid-radial pulse wave velocity and augmentation index to evaluate endothelial function and arterial stiffness among 57 women obtaining anthracycline-based and HER-2 chemotherapy. These medications did cause a reduction in LVEF as previously described. There was a significant decrease in flow mediated dilation at 6 months and an increase in pulse wave velocity, but these were not correlated with the reduction in ejection fraction. Augmentation index was unchanged.

IV.C. Cardiac surveillance during breast cancer treatment; a snapshot of current practice
By Yvonne Koop

• The authors described current cardiac surveillance for patients with breast cancer during and after cancer treatment using observational data collected at hospitals in the Netherlands from 2012 to 2015. Among all the 16,040 newly diagnosed patients with breast cancer, cardiac care was provided for 27.3% individuals and included cardiology-specific laboratory tests (e.g., troponin) in 0.6%, echocardiography in 11.5%, and multigated acquisition in 9.6%. Imaging or cardiac care was obtained in 36.6% of those on chemotherapy, 49.7% of those receiving immunotherapy, and 31.7% of those receiving radiation therapy.

IV.D. Early detection of left ventricular dysfunction after breast cancer radiotherapy using speckle tracking echocardiography: association between cardiac exposure and myocardial strain changes (BACCARAT)
By Sophie Jacob

• The authors sought to characterize the impact of radiation therapy and myocardial longitudinal strain in 94 patients with breast cancer. They noted a significant decrease in longitudinal strain in those receiving left-sided radiation therapy (-15.5 ± 3.7% before RT vs. -14.1 ± 4.0% at RT +6 months; p = 0.02) but not right-sided (-15.0 ± 4.2% vs. -15.0 ± 4.2%; p = 0.99). Mean dose to the heart and LV were significantly associated with decreased GLS at 6 months post-RT.

V. Other Outcomes

V.A. Cardiovascular adverse events associated with BRAF and MEK inhibitors
By Raluca-Ileana Mincu

• The authors completed a meta-analysis to determine the rate of cardiovascular adverse events following treatment with B-Raf proto-oncogene serine/threonine kinase inhibitors and mitogen-activated protein kinase (BRAF/MEK) inhibitors in 4,616 patients with melanoma. The treatment with BRAF/MEK inhibitors was associated with an increased risk of a decrease in LVEF, pulmonary embolism, AF, and arterial hypertension. Subgroup analysis showed that the combination therapy with BRAF/MEK inhibitors resulted in a higher risk of a decrease in LVEF, pulmonary embolism, and arterial hypertension, and the risk for AF was increased in BRAF inhibitors monotherapy group compared to controls. The relative risks of MI, CHF, pericarditis, and QTc prolongation were similar between the BRAF/MEK inhibitors group and control group.

V.B. Cardiovascular toxicity following modern multiple myeloma therapy in Japanese cohort
By Tatsuhiro Shibata

• The authors analyzed 42 patients with MM who received anti-MM therapies. Within the 408-day median follow-up period (range 15-844 days), cardiac adverse events occurred in 23.8% (n = 10); CHF/cardiomyopathy in 11.9%, newly diagnosed AF in 4.8%, venous thromboembolism in 4.8%, vasospastic angina in 2.4%, and death in 28.6%.

V.C. Is sacubitril/valsartan useful in patients with cancer and heart failure? Data from HF-COH spanish multicenter registry
By Ana Martin Garcia

• The authors analyzed the potential benefit of sacubitril/valsartan in specific cardio-oncology clinics in 6 Spanish hospitals. A total of 61 patients was followed for a median 7.2 months. Most of the patients (97%) had cancer therapy-related cardiac dysfunction with a median time from anti-cancer therapy to cancer therapy-related cardiac dysfunction of 40 months. In 5%, sacubitril/valsartan was initiated at cancer therapy-related cardiac dysfunction diagnosis. In 95%, sacubitril/valsartan was started to improve clinical status in patients already treated with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Baseline NT-proBNP levels, functional class, and LVEF improved at the end of follow-up in patients who continued with sacubitril/valsartan (all p values = 0.01).

V.D. Chemoradiation therapy to patients with lung cancer exacerbates thoracic aortic calcification
By Takashi Miki

• The purpose of this study was to evaluate whether chemoradiation therapy (CRT) would exacerbate thoracic aortic calcification. A total of 68 patients who were treated for lung cancer was retrospectively analyzed, of whom 35 underwent surgical treatment after induction CRT (CRT group) and 33 underwent surgical treatment alone (control group). In univariate analysis, the annual percent change in thoracic aortic calcification volume was significantly increased in the CRT group compared with the control group (37.6% vs. 23.3%; p = 0.006). Multivariate logistic regression analysis demonstrated that CRT was an independent factor associated with the progression of thoracic aortic calcification volume, even after adjustment for baseline calcification volume and coronary risk factors (OR 3.90; 95% CI, 1.32-11.47; p = 0.014).

V.E. Late adverse effects of residual platinum concentrations on cardiac function in testicular cancer survivors: a 30-year follow-up study
By Anders Wold Bjerring

• The authors assessed the relationship between residual serum platinum concentrations and changes in cardiac function and morphology in 70 testicular cancer survivors (mean age 60) 30 years after treatment with cisplatin-based chemotherapy. They found no evidence of difference in cardiac function or chamber sizes between patients with high and low residual platinum concentrations.

V.F. Moderate anti-tumor effect of the nanoliposomal anti-PCSK9 vaccine in BALB/c mice bearing colorectal cancer and breast cancer
By Maciej Banach

• Higher levels of low-density lipoprotein cholesterol have been reported to correlate with higher prevalence and risk of colon cancer. The authors evaluated the anti-tumor effect of nanoliposomal anti-PCSK9 vaccine in mice with colon cancer. They injected BALB/c anti-PCSK9 four times biweekly, then inoculated the mice with CT26 colon cancer cells into the right flank. They found that tumor size in the vaccinated mice was significantly lower compared with control, and the vaccinated mice's survival was prolonged by 24.4%. Similar findings were noted when mice were inoculated with breast cancer cells.

V.G. Incidence of events between vitamin K antagonists and direct oral anticoagulants in patients with cancer
By Ana Pardo Sanz

• The authors sought to evaluate the effectiveness and safety of DOACs and VKAs within patients with breast cancer in an observational multicenter study of 637. The incidence of ischemic stroke/systemic embolism (HR 0.91; 95% CI, 0.42-1.99) or bleeding events (HR 1.53; 95% CI, 0.93-2.53) in patients with cancer either on VKA or DOAC after adjustment for CHA2DS2-VASc and HAS-BLED, respectively.

VI. ACS, PCI, Transcathether Aortic Valve Replacements, and Other Procedures

VI.A. Percutaneous coronary intervention and clinical outcomes in patients with lymphoma: a 10-year period United States nationwide inpatient sample (NIS) analysis
By Josip Andjelo Borovac

• The authors report procedural outcomes in patients who underwent percutaneous coronary intervention (PCI) and had a concurrent diagnosis of Hodgkin lymphoma or NHL. Patients with lymphoma were more likely to experience in-hospital mortality (OR 1.34; 95% CI, 1.20-1.49), stroke or transient ischemic attack (OR 1.59; 95% CI, 1.47-1.73), and any in-hospital complication (OR 1.19; 95% CI, 1.14-1.25) following PCI. In subgroup analysis, Hodgkin lymphoma was more likely to be associated with these increased risks compared with NHL.

VI.B. Association between bleeding after acute coronary syndrome and newly diagnosed cancers
By Isabel Munoz Pousa

• The authors determined whether post-discharge bleeding in patients with acute coronary syndrome (ACS) was predictive of a new cancer diagnosis. In 3,644 patients with ACS discharged with dual antiplatelet therapy, during a median follow-up of 56.2 months, bleeding events were documented in 1,215 patients and new cancers in 227 patients. After multivariable adjustment, post-discharge bleeding (notably gastrointestinal, genitourinary, and bronchopulmonary) was associated with cancer diagnosis (adjusted HR 3.43; 95% CI, 2.62-4.50).

VI.C. Impact of radiotherapy on myocardial function and paravalvular leaks after transcatheter aortic valve implantation (TAVI)
By Marianna Cicenia

• The authors assessed the impact of RT on the clinical and echocardiographic outcomes of patients with severe aortic stenosis treated with transcatheter aortic valve implantation. Of 102 patients, 19 had a history of cancer and were treated with radiation. No differences in terms of in-hospital clinical outcomes were observed. There was a higher incidence of at least moderate degree paraprosthetic leaks in the oncologic group (37%) versus the non-oncologic group (12%). After 3-6 months, there was no significant improvement in ejection fraction or longitudinal strain in patients with cancer compared with patients without cancer.

VI.D. Long-term outcomes in patients with cancer undergoing percutaneous coronary intervention: analysis from a Japan multicenter registry
By Ayaka Endo

• The authors described the prevalence and long-term outcomes of patients with cancer undergoing PCI. A total of 4,455 patients, of whom 173 had cancer, underwent PCI at 15 hospitals within metropolitan Tokyo from September 2008 to 2012 and were followed for 2 years. Patients with cancer with acute and stable presentation had significantly higher risk of all-cause mortality (HR 8.01; 95%; p < 0.001 and HR 5.53; 95%; p < 0.001, respectively) and major acute cardiovascular and cerebrovascular events (HR 2.38; p < 0.001, HR 2.33; p = 0.001, respectively) compared with patients without cancer.

VI.E. Pericardiocentesis in thrombocytopenic cancer patients
By Michelle Lee

• The authors evaluated impact of platelet count on the survival of 137 thrombocytopenic (<150 x 10³ platelets/mL) patients with cancer who underwent pericardiocentesis. They found that the cumulative survival of patients at 30 days was 63% in Grade 1 thrombocytopenia (<50 x 10³ platelets/mL), 67% in Grade 2 (51-100 x 10³ platelets/mL), and 83% in Grade 3 (101-149 x 10³ platelets/mL). Aside from only 1 patient with a hematoma, there were no periprocedural complications, notably in those with Grade 1 thrombocytopenia.

VI.F. Long-term cardiovascular outcomes after percutaneous coronary interventions in patients with acute coronary syndrome and cancer
By Yue Ma

• The authors sought to compare post-ACS outcomes of patients with lung cancer compared with other types of cancer. They reviewed outcomes of 337 with a history of cancer prior to ACS; 15.1% (n = 51) had a medical history of lung cancer. They found that the incidence of cardiovascular death (5.9% vs. 1.0%; p = 0.02) was higher in the lung cancer group compared with other cancers.

VI.G. Ischemic and bleeding risk after an acute coronary syndrome in patients with prior history of cancer treated with dual antiplatelet therapy
By Isabel Munoz Pousa

• The authors sought to evaluate bleeding risk in patients with cancer undergoing PCI and treated with dual antiplatelet therapy combining 3 clinical registries (BleeMACS [Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome; 2004-2013], CardioCHUVI/ARRITXACA [2010-2016], and RENAMI [Registry of New Antiplatelets in Patients with Myocardial Infarction; 2013-2016]), including a total of 26,076 patients, 1,661 of whom had cancer. In a propensity-matched analysis, the authors found that the patients with prior cancer showed a significantly higher risk of acute MI (HR 1.44; 95% CI, 1.01-2.04; p = 0.044) but not higher risk of major bleeding (HR 1.21; 95% CI, 0.88-1.68; p = 0.248) compared with those without prior cancer.

VI.H. Acute Myocardial Infarction in patients with Leukaemia: A national analysis of prevalence, predictors and outcomes in United States hospitalisations (2004 to 2014)
By Mohamed Mohamed

• This study examined the prevalence and clinical characteristics of patients with leukemia presenting with acute MI and evaluated differences in clinical outcomes according to the subtype of leukemia. Out of 6,750,927 acute MI admissions, a total of 21,694 patients had a leukemia diagnosis. The leukemia group experienced higher rates of major acute cardiovascular and cerebrovascular events (11.8% vs. 7.8%), mortality (10.3% vs. 5.8%), and bleeding (5.6% vs. 5.3%). Patients with leukemia were less likely to undergo coronary angiography (48.5% vs. 64.5%) and PCI (28.2% vs. 42.9%) compared with those without leukemia.

VI.I. Cancer is not associated with increased cardiac and bleeding events after 2nd- and 3rd-generation drug-eluting stents implantation
By Yusuke Muramatsu

• The authors aimed to clarify the impact of cancer on clinical outcomes in patients after second- or third-generation drug-eluting stent implantation. A total of 932 patients who had cancer before PCI and underwent PCI with second- or third-generation drug-eluting stent was included. The incidence of major adverse cardiovascular events at median 577 (340-1043) days after the PCI was comparable between the 2 groups (cancer group: n = 140; no-cancer group: n = 792), although the incidence of all-cause death in the cancer group was significantly greater than the no-cancer group (15.1% vs. 9.5%; p = 0.007 in the adjusted cohort).

Clinical Topics: Acute Coronary Syndromes, Anticoagulation Management, Arrhythmias and Clinical EP, Cardiac Surgery, Cardio-Oncology, Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Pericardial Disease, Prevention, Pulmonary Hypertension and Venous Thromboembolism, Stable Ischemic Heart Disease, Valvular Heart Disease, ACS and Cardiac Biomarkers, Anticoagulation Management and ACS, Anticoagulation Management and Atrial Fibrillation, Anticoagulation Management and Venothromboembolism, Implantable Devices, EP Basic Science, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Aortic Surgery, Cardiac Surgery and Arrhythmias, Cardiac Surgery and CHD and Pediatrics, Cardiac Surgery and Heart Failure, Cardiac Surgery and SIHD, Cardiac Surgery and VHD, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Imaging, CHD and Pediatrics and Interventions, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Lipid Metabolism, Nonstatins, Statins, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Pulmonary Hypertension, Interventions and ACS, Interventions and Imaging, Interventions and Structural Heart Disease, Interventions and Vascular Medicine, Angiography, Computed Tomography, Echocardiography/Ultrasound, Magnetic Resonance Imaging, Nuclear Imaging, Hypertension, Chronic Angina

Keywords: ESC Congress, ESC 19, Acute Coronary Syndrome, Aminobutyrates, Angiogenesis Inhibitors, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Anthracyclines, Anticoagulants, Antimetabolites, Antineoplastic Combined Chemotherapy Protocols, Aortic Valve, Aortic Valve Stenosis, Atrial Fibrillation, Biomarkers, Blood Platelets, Body Mass Index, Bradycardia, Brain Ischemia, Breast Neoplasms, Cardiomyopathies, Cardiotoxicity, Cardiovascular Diseases, Cholesterol, LDL, Cisplatin, Cohort Studies, Colonic Neoplasms, Colorectal Neoplasms, Confidence Intervals, Control Groups, Coronary Vasospasm, Coronary Angiography, C-Reactive Protein, Cyclophosphamide, Defibrillators, Diabetes Mellitus, Dilatation, Doxorubicin, Drug-Eluting Stents, Echocardiography, Echocardiography, Three-Dimensional, Epirubicin, Fibrinolytic Agents, Fluorodeoxyglucose F18, Fluorouracil, Follow-Up Studies, Genetic Diseases, X-Linked, Graft vs Host Disease, Heart Arrest, Heart Failure, Hematologic Neoplasms, Hematoma, Hematopoietic Stem Cell Transplantation, Hepatic Veno-Occlusive Disease, Hodgkin Disease, Hospital Mortality, Hospitals, Rural, Hypertension, Hypertension, Pulmonary, Ifosfamide, Immunotherapy, Incidence, Inflammation, Inpatients, Ischemic Attack, Transient, Leukemia, Leukemia, L-Lactate Dehydrogenase, Logistic Models, Long QT Syndrome, Lung Neoplasms, Lymphoma, Non-Hodgkin, Magnetic Resonance Imaging, Melanoma, Mice, Inbred BALB C, Mitogen-Activated Protein Kinases, Mitral Valve, Multiple Myeloma, Myocardial Infarction, Natriuretic Peptide, Brain, Neoplasms, Germ Cell and Embryonal, Neutrons, Odds Ratio, Pacemaker, Artificial, Paclitaxel, Peptide Fragments, Patient Discharge, Pericardiocentesis, Percutaneous Coronary Intervention, Pericarditis, Platelet Aggregation Inhibitors, Platelet Count, Positron-Emission Tomography, Prednisolone, Prednisone, Prevalence, Natriuretic Peptides, Prognosis, Prospective Studies, Proto-Oncogene Proteins, Proto-Oncogenes, Pulmonary Embolism, Pulse Wave Analysis, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Sick Sinus Syndrome, Sinoatrial Block, Stroke, Stroke Volume, Tertiary Care Centers, Testicular Neoplasms, Tetrazoles, Thalidomide, Thrombocytopenia, Tolnaftate, Transcatheter Aortic Valve Replacement, Troponin, Troponin T, Tumor Burden, Vaccines, Vascular Stiffness, Venous Thromboembolism, Ventricular Dysfunction, Left, Ventricular Function, Left, Vincristine, Vitamin K

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