Inflammation-based association between anatomical severity of coronary heart disease and lung cancer

Objective: to study a relationship between coronary heart disease (CHD) and lung cancer is the subject of numerous studies, since both diseases have common risk factors (smoking, age, genetics, environmental factors, obesity, diabetes, physical inactivity, stress) and pathogenetic mechanisms (chronic inflammation, oxidative stress and endothelial dysfunction).

Materials and methods: the study period covers the time period from January 1, 2015 to June 1, 2024. Patients who underwent planned myocardial revascularization at the Research Institute — Regional Clinical Hospital No. 1 n. a. Prof. S.V. Ochapovsky, Krasnodar (chief physician — Corresponding Member of the Russian Academy of Sciences V.A. Porkhanov) were analyzed. A lung tumor was diagnosed in 165 patients in the preoperative period, which required surgical removal followed by histological verification. Lung cancer was verified in 89 patients (group A) and benign lung neoplasm was diagnosed in 76 patients (group B).

Results: there were no significant differences in gender, age and anamnestic data between patients with and without lung cancer. In patients with lung cancer, the anatomical severity of coronary heart disease calculated by the SYNTAX scale (SX) was higher than in patients without cancer (median: 12.00, interquartile range: 4.55–21.01 vs. median: 9.00, interquartile range: 3.00–14.28, p = 0.036). SX was defined as high (SXhigh) with a value of >16, low (SXlow) ≤16. Neutrophilto-lymphocyte ratio (NLR) was determined in all patients and was defined as high (NLR-high) if the value was >2.23 and low (NLR-low) if the value was ≤2.23. Among all patients, patients with lung cancer had a higher frequency of SXhigh compared with patients without cancer (35.96% vs. 19.73, p=0.021). Moreover, among patients with NLR-high, patients with lung cancer had a higher frequency of SXhigh than patients without cancer (50.82% vs. 25.0%, p=0.044), but among patients with lung cancer, the percentage of SXhigh was not significantly higher than in patients without cancer among patients with NLR-low (21.43% vs. 19.64%, p=0.850). Multivariate logistic regression analysis showed that SXhigh was associated with an increased risk of lung cancer with an odds ratio of 1.834 (95% CI: 1.063–3.162, p=0.029).

Conclusions: it was demonstrated that the anatomical severity of CAD was associated with lung cancer, but the association of the two diseases was significant among patients with high inflammation than among patients with low inflammation. The results indicated that inflammation may play an important role in the association between CAD and lung cancer.

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