Association of cancer on coronary atherosclerotic burden and plaque rupture: Insights from the BRAVADO study.
| Title: | Association of cancer on coronary atherosclerotic burden and plaque rupture: Insights from the BRAVADO study. |
|---|---|
| Authors: | Seleme VB; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Universidade Positivo (UP), Curitiba, Brazil. Electronic address: viniciusbseleme@yahoo.com.br.; da Silva Costa IBS; Cancer Institute (ICESP, Universidade de São Paulo (USP), São Paulo, Brazil.; Pileggi B; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil.; de Barros Branco CE; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Hospital Albert Einstein, São Paulo, Brazil.; Rizk SI; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Cancer Institute (ICESP, Universidade de São Paulo (USP), São Paulo, Brazil.; de Medeiros Lopes MAAA; Real Hospital Portugues, Recife, Brazil.; Campanha Borges DC; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil.; Campos RN; Hospital Beneficência Portuguesa, São Paulo, Brazil.; de Brito FS; Hospital Sírio Libanês, São Paulo, Brazil.; Abdalla Sanches JM; Hospital Sírio Libanês, São Paulo, Brazil.; Godinho RR; Instituto Prevent Senior, São Paulo, Brazil.; Esper RB; Instituto Prevent Senior, São Paulo, Brazil.; Faillace B; Hospital Porto Dias, Belém, Brazil.; Precoma DB; Hospital Angelina Caron, Campina Grande do Sul, Brazil.; Ribeiro MH; Hospital SOS Cardio, Florianópolis, Brazil.; Seabra-Garcez JD; Hospital São Lucas, São Luiz, Brazil.; Nunes Ferreira AF; Centro Universitário Faculdade de Medicina ABC, Santo André, Brazil.; Kalil Filho R; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Hospital Sírio Libanês, São Paulo, Brazil.; Abizaid A; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil.; Hajjar LA; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Cancer Institute (ICESP, Universidade de São Paulo (USP), São Paulo, Brazil.; Campos CM; Heart Institute (InCor), Universidade de São Paulo (USP), São Paulo, Brazil; Instituto Prevent Senior, São Paulo, Brazil. Electronic address: carlosacampos1@gmail.com. |
| Source: | Atherosclerosis [Atherosclerosis] 2026 Apr; Vol. 415, pp. 120683. Date of Electronic Publication: 2026 Feb 19. |
| Publication Type: | Journal Article; Observational Study; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Ireland NLM ID: 0242543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1484 (Electronic) Linking ISSN: 00219150 NLM ISO Abbreviation: Atherosclerosis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Limerick : Elsevier; Original Publication: Amsterdam, Elsevier. |
| MeSH Terms: | Plaque, Atherosclerotic*/diagnostic imaging ; Plaque, Atherosclerotic*/epidemiology ; Coronary Artery Disease*/epidemiology ; Coronary Artery Disease*/diagnostic imaging ; Neoplasms*/epidemiology ; Neoplasms*/complications ; Neoplasms*/diagnosis ; Acute Coronary Syndrome*/epidemiology ; Acute Coronary Syndrome*/diagnostic imaging; Humans ; Male ; Female ; Middle Aged ; Aged ; Coronary Angiography ; Rupture, Spontaneous ; Risk Factors ; Risk Assessment |
| Abstract: | Background and Aims: Cardiovascular diseases and cancer represent leading global causes of mortality, sharing common risk factors. However, the specific impact of cancer on atherosclerotic plaque burden and coronary lesion complexity in acute coronary syndrome (ACS) remains understudied. We aim to compare coronary atherosclerotic burden as assessed by coronary angiography in cancer patients with ACS to those without cancer, including ACS and chronic disease.; Methods: This was a multicenter, ambispective observational study conducted between September 2016 and December 2022, involving detailed analysis of clinical records and invasive coronary angiograms. Patients were classified into three cohorts: (1) individuals presenting with acute coronary syndrome (ACS) and a prior history of cancer (ACSC), (2) ACS patients without any history of malignancy (ACSNC), and (3) patients with stable chronic coronary artery disease (CCAD). To reduce confounding, propensity score matching was applied to balance baseline characteristics between the ACSC and ACSNC groups. Comparative assessments focused on the presence of plaque rupture, angiographic complexity, and overall coronary atherosclerotic burden across the three cohorts.; Results: 618 patients were included, comprising 206 individuals each in the ACSC, ACSNC, and CCAD groups. A total of 3752 coronary lesions were analyzed. The most common types of cancer were prostate, hematological, and colorectal cancer. Patients with acute presentation had more eccentric and ulcerated lesions, involving bifurcations, and resulted in worse SYNTAX and Leaman scores when compared to chronic coronary artery disease (p values |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: There are no additional interest conflicts related to the subject discussed in this scientific article. |
| Contributed Indexing: | Keywords: Acute coronary syndrome; Atherosclerotic plaque burden; Cancer; Coronary artery disease; syntax score |
| Molecular Sequence: | ClinicalTrials.gov NCT04222608 |
| Entry Date(s): | Date Created: 20260228 Date Completed: 20260423 Latest Revision: 20260423 |
| Update Code: | 20260424 |
| DOI: | 10.1016/j.atherosclerosis.2026.120683 |
| PMID: | 41763067 |
| Database: | MEDLINE |
Journal Article; Observational Study; Multicenter Study