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J Intern Med. 2005 Aug;258(2):124-32.

Cancer risk of patients with ischaemic syndromes.

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Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.



Angiogenesis constitutes the regulation of collateral formation in subjects with ischaemic syndromes and is also a prerequisite for cancer progression. Patients with severe symptomatic ischaemic syndromes may have a reduced ability for angiogenesis and thus a lower risk to develop cancer.


Patients below 80 years and treated for acute myocardial infarction (AMI), angina pectoris (AP), intermittent claudication (IC) or undergoing revascularization during 1972-1991 in Stockholm county (n=63 921) were followed regarding cancer incidence 1972-2000. Cancer incidence was compared with that of the general population of Stockholm County by standardized incidence ratios (SIR).


An increased incidence of cancer overall compared with the general population was seen in patients treated for AMI [SIR men 1.08 (95% Confidence Interval 1.04-1.11) and women 1.15 (1.09-1.21)], AP [men 1.16 (1.11-1.21) and women 1.06 (1.00-1.12)] and IC [men 1.48 (1.31-1.64) and women 1.43 (1.17-1.68)]. This increase was mainly due to an increased incidence of tobacco-related cancer. In patients undergoing revascularization no increase in incidence was seen [SIR men 0.97 (0.91-1.03) and women 1.06 (0.91-1.20)].


Patients with mild to moderate symptomatic ischaemic syndromes are, as expected, at increased risk of subsequently develop tobacco-related cancer. A lack of increased cancer risk in patients undergoing revascularization could be due to a reduced ability for angiogenesis in patients with severe atherosclerotic disease but may also be related to lifestyle changes.

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