Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Abstract

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.

Temporal changes in treatments and outcomes after acute myocardial infarction among cancer survivors and patients without cancer, 1995 to 2013

“…26 Another study indicated that patients who were diagnosed with cancer up to 1 year before receipt of PCI did not experience worse long-term cardiovascular outcomes compared with those who did not have cancer. 27 We observed that cancer survivors aged 65 years received similar rates of post-AMI cardiovascular pharmacotherapies, except for marginally less rates of ACEi/ARB, oral anticoagulants, and statins. The precise reason for less prescription of these medications is difficult to discern from our data set given the lack of granular data.…”

“…Analysis of a multicenter registry suggested that patients who had a cancer diagnosis up to, but not longer than, 6 months before an AMI and received PCI had significantly worse 1‐year mortality compared with patients without cancer who had an AMI . Another study indicated that patients who were diagnosed with cancer up to 1 year before receipt of PCI did not experience worse long‐term cardiovascular outcomes compared with those who did not have cancer …”

Health care utilization and mortality associated with heart failure‐related admissions among cancer patients

“…28 However, available data offer conflicting views on the safety of these procedures among lower-risk cancer patients. 29,30 Additionally, patients with cancer had higher 30 day readmission rates than had non-cancer patients; however, HF-related readmission rates were higher in the non-cancer cohort, when compared with cancer patients. This discrepancy is likely related to cancer-specific morbidities such as infection, anaemia, or thrombosis.…”

Sımultaneous Lung Cancer And Heart Dısease

“…Eş zamanlı kanser ve kalp damar hastalığı tedavisi ile ilgili yayınlar son yıllarda artmakla birlikte yeterli sayı ve çeşitliliğe ulaşmamıştır (4,5). Yayınlardaki hasta sayıları az, takip süreleri kısadır.…”