title: Is there coronary artery disease in the cancer patient who manifests with chest pain, shortness of breath and/or tachycardia? A retrospective observational cohort.
abstract: OBJECTIVE
  Cancer therapies lead to chest pain (CP), shortness of breath (SOB), and/or tachydysrhythmias (TACH Y) requiring cardiac risk stratification including coronary computed tomographic angiography (CCTA). We posit that cancer patients with CP, SOB and/or TACH Y have greater odds of having coronary artery disease (CAD) identified by CCTA than those that do not.
  
  
  METHODS
  Eligibility for this IRB-approved retrospective observational cohort included those with cancer that had CCTA performed. Groups were stratified with and without CP, SOB, and/or TACH Y. Electronic medical records were mined for appropriate CPT codes from 01012010 to 08312013. Demographics, cancer type, and clinical outcomes were obtained. Standard t tests, odds ratios, and frequencies were used.
  
  
  RESULTS
  Of 176 participants identified; 84 were male (48 %) and 118 were Caucasian (67 %). Of those, 100/176 (57 %) had CP, SOB, and/or TACH Y; 72/100 (72 %) had CP; 10/100 (10 %) had TACH Y; and 18/100 (18 %) had SOB. Of the 72 with CP, 40 (56 %) had CAD; of the 10 with TACH Y, 6 (60 %) had CAD; of the 18 with SOB, and 10 (56 %) had CAD. Thus, a 2.6-fold increased odds of having CAD (56/100 = 56 %) compared to 25/76 (33 %) in the group with cancer without CP, SOB, and/or TACH Y (95 % CI = 1.40 to 4.83; p = 0.003).
  
  
  CONCLUSIONS
  Cancer patients with CP, SOB, and/or TACH Y have a 2.6-fold increased odds of having CAD compared to cancer patients without CP, SOB, and/or TACH Y (95 % CI = 1.40 to 4.83; p = 0.003).
authors.affiliation: Department of Emergency Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd Unit 1468, 77030, Houston, TX, USA, Ahmiller@mdanderson.org.
authors.forename: Adam H
authors.initials: AH
authors.lastname: Miller
authors.forename: Maria Teresa Cruz
authors.initials: MT
authors.lastname: Carreras
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Miller
authors.forename: Hannah E
authors.initials: HE
authors.lastname: Miller
authors.forename: Valda D
authors.initials: VD
authors.lastname: Page
mesh_terms: D000328:Adult; D002637:Chest Pain / Q000209:etiology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D013610:Tachycardia / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014481:United States / Q000453:epidemiology