Outcome After ST Elevation Myocardial Infarction in Patients With Cancer Treated With Primary Percutaneous Coronary Intervention

Velders, Matthijs A.; Boden, Helèn; Hofma, Sjoerd H.; Osanto, Susanne; Hoeven, Bas L. van der; Heestermans, A. A. C. M.; Cannegieter, Suzanne C.; Jukema, J. Wouter; Umans, Victor; Schalij, Martin J.; Boven, A.J. van

doi:10.1016/j.amjcard.2013.08.019

Cited by 104 publications

(84 citation statements)

References 18 publications

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“…Our findings correlate with other studies [15,16,17] which examined the outcomes of STEMI in cancer patients. Cancer patients were older and included more females and those who suffered more from anemia.…”

Section: Discussionsupporting

confidence: 82%

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

Mazin

Matetzky²,

Shemer³

et al. 2017

Cardiology

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Objectives: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). Methods: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015. Patients with malignancies (n = 256) were divided into 2 groups: those with solid and those with homogenous tumors. Results: The time of diagnosis was categorized into 3 patient groups: recent (<6 months), 59 patients (23%); late (6-24 months), 49 patients (19%), and very late (>24 months), 148 patients (58%). Those with a history of malignancy were older (73 ± 12 vs. 64 ± 15, p < 0.001) and were more likely to be female (p = 0.002). After using a multivariate logistic regression model analysis, no differences were found in therapeutic interventions and clinical outcomes, including major bleeding and acute renal failure, between patients with and without malignancies. Conclusions: Patients with a malignancy comprised about 10% of the entire ICCU population. While mortality was independently associated with advanced age, renal failure, and a diagnosis of ST-elevation myocardial infarction, malignancy alone was not found to be independently associated with a higher mortality rate at 30 days of follow-up.

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Section: Discussionsupporting

confidence: 82%

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

Mazin

Matetzky²,

Shemer³

et al. 2017

Cardiology

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“…Despite potential associations between cancer and PCI outcomes, there have been few opportunities to study this topic. Literature in this area has been limited to reports of stent thrombosis following PCI in cancer patients and a recent study of 3423 Dutch patients undergoing primary PCI for ST‐segment elevation myocardial infarction from 2006 to 2009, which demonstrated that pre‐PCI cancer was associated with increased short‐term mortality . Several reasons account for the paucity of data in this field.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Hess

Roe

Clare

et al. 2015

JAHA

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BackgroundCardiovascular disease and cancer increasingly coexist, yet relationships between cancer and long-term cardiovascular outcomes post–percutaneous coronary intervention (PCI) are not well studied.Methods and ResultsWe examined stented PCI patients at Duke (1996–2010) using linked data from the Duke Information Systems for Cardiovascular Care and the Duke Tumor Registry (a cancer treatment registry). Our primary outcome was cardiovascular mortality. Secondary outcomes included composite cardiovascular mortality, myocardial infarction, or repeat revascularization and all-cause mortality. We used adjusted cause-specific hazard models to examine outcomes among cancer patients (cancer treatment pre-PCI) versus controls (no cancer treatment pre-PCI). Cardiovascular mortality was explored in a cancer subgroup with recent (within 1 year pre-PCI) cancer and in post-PCI cancer patients using post-PCI cancer as a time-dependent variable. Among 15 008 patients, 3.3% (n=496) were cancer patients. Observed rates of 14-year cardiovascular mortality (31.4% versus 27.7%, P=0.31) and composite cardiovascular death, myocardial infarction, or revascularization (51.1% versus 55.8%, P=0.37) were similar for cancer versus control groups; all-cause mortality rates were higher (79.7% versus 49.3%, P<0.01). Adjusted risk of cardiovascular mortality was similar for cancer patients versus controls (hazard ratio 0.95; 95% CI 0.76 to 1.20) and for patients with versus without recent cancer (hazard ratio 1.46; 95% CI 0.92 to 2.33). Post-PCI cancer, present in 4.3% (n=647) of patients, was associated with cardiovascular mortality (adjusted hazard ratio 1.51; 95% CI 1.11 to 2.03).ConclusionsCancer history was present in a minority of PCI patients but was not associated with worse long-term cardiovascular outcomes. Further investigation into PCI outcomes in this population is warranted.

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“…Clinical series have suggested that these arterial thromboembolic events may be common in patients with cancer (8–12). Population-based data, however, are scarce regarding the association between cancer, broadly defined, and arterial thromboembolism, with most previous investigations focused on individual cancer types or specific arterial events (13–26).…”

Section: Introductionmentioning

confidence: 99%

Risk of Arterial Thromboembolism in Patients With Cancer

Navi

Reiner

Kamel

et al. 2017

Journal of the American College of Cardiology

525

439

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Background The risk of arterial thromboembolism in patients with cancer is incompletely understood. Objectives The authors aimed to better define this epidemiological relationship, including the effects of cancer stage. Methods Using the Surveillance Epidemiology and End Results-Medicare linked database, we identified patients with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, pancreatic, or gastric cancer or non-Hodgkin lymphoma from 2002 through 2011. They were individually matched by demographics and comorbidities to a Medicare enrollee without cancer, and each pair was followed through 2012. Validated diagnosis codes were used to identify arterial thromboembolism, defined as myocardial infarction or ischemic stroke. Cumulative incidence rates were calculated using competing risk survival statistics. Cox hazards analysis was used to compare rates between groups at discrete time points. Results We identified 279,719 pairs of patients with cancer and matched controls. The 6-month cumulative incidence of arterial thromboembolism was 4.7% (95% confidence interval [CI]: 4.6% to 4.8%) in patients with cancer compared to 2.2% (95% CI: 2.1% to 2.2%) in controls (HR: 2.2; 95% CI: 2.1 to 2.3). The 6-month cumulative incidence of myocardial infarction was 2.0% (95% CI: 1.9% to 2.0%) in patients with cancer compared with 0.7% (95% CI: 0.6% to 0.7%) in controls (HR: 2.9; 95% CI: 2.8 to 3.1). The 6-month cumulative incidence of ischemic stroke was 3.0% (95% CI: 2.9% to 3.1%) in patients with cancer compared to 1.6% (95% CI: 1.6% to 1.7%) in controls (HR: 1.9; 95% CI: 1.8 to 2.0). Excess risk varied by cancer type (greatest for lung), correlated with cancer stage, and generally had resolved by 1 year. Conclusions Patients with incident cancer face a substantially increased short-term risk of arterial thromboembolism.

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Outcome After ST Elevation Myocardial Infarction in Patients With Cancer Treated With Primary Percutaneous Coronary Intervention

Cited by 104 publications

References 18 publications

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Risk of Arterial Thromboembolism in Patients With Cancer

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