As the aging population has progressed and oncology treatments have revolutionized, the clinical situation of cardiovascular disease complicating malignancy has become more common, and the field of cardio-oncology has gained much attention. When hematological malignancy is combined with coronary heart disease, the condition can be aggravated by pathological mechanisms such as imbalance of oxygen supply and bleeding coagulation abnormalities. However, the factors affecting the prognosis have rarely been reported.

To investigate the influencing factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

Data from the medical records of General Hospital of Southern Theater Command between January 2013 and December 2020 were retrieved to select patients whose diagnostic book homepage contained the keywords coronary heart disease or coronary atherosclerotic heart disease and hematological malignancy (leukemia or lymphoma or multiple myeloma) to establish a repository of patients with coronary heart disease combined with hematological malignancy. Patients' clinical data were collected and followed up for survival status, major adverse cardiovascular events (MACE) and the occurrence or absence and time of major bleeding events. They were divided into survival and death groups by survival status, and statistical analysis was performed for each indicator in the two groups. Multivariate Cox regression analysis was used to explore the risk factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

A total of 68 patients were finally included in the study, 52 died (76.47%) , the median survival time was 10.93 months, and the median follow-up time was 67.33 months. Compared with the survival group, patients in the death group were older, had faster heart rate at admission, lower body mass index, smaller body surface area, lower hemoglobin, albumin level, higher cystatin C level, higher proportion of elevated brain natriuretic peptide, and higher proportion of chemotherapy and stem cell transplantation (P<0.05) . Multivariate Cox regression analysis showed that elevated body mass index〔HR=0.841, 95%CI (0.761, 0.930) , P=0.001〕, receipt of chemotherapy〔HR=0.340, 95%CI (0.182, 0.637) , P=0.001〕, increased albumin level〔HR=0.934, 95%CI (0.889, 0.982) , P=0.008〕 were independent protective factors for death events. Elevated fibrinogen〔HR=1.635, 95%CI (1.291, 2.071) , P<0.001〕, and platelet count less than 100×10⁹/L〔HR=2.500, 95%CI (1.336, 4.678) , P=0.004〕 were independent risk factors for mortality.

Patients with coronary heart disease and hematological malignancies have poor prognosis, and the risk factors associated with all-cause mortality are elevated fibrinogen and platelet count less than 100×10⁹/L.