Long-term outcomes after percutaneous coronary interventions in cancer survivors.
BACKGROUND
Cancer patients are mostly excluded from percutaneous coronary intervention (PCI) clinical trials and oncologic history is lacking from most PCI registries. Thus, little is known about the clinical outcomes following PCI among cancer survivors. Our aim was to examine the prevalence and long-term outcome of cancer survivors among a large PCI patient cohort.


METHODS
We retrospectively integrated and analyzed cardiovascular and oncologic data of 12 785 consecutive patients who underwent PCI between April 2004 and October 2014. Cancer survivors were compared with pair-matched cancer-naive patients.


RESULTS
Cancer survivors constituted 7.8% (1005) of the patients. The mean cancer diagnosis-to-PCI interval was 3.6±3.4 years and the mean post-PCI follow-up was 6.4±5.9 years. Postmatching baseline characteristics were similar between the groups. Cancer survivors were referred to the catheterization laboratory because of acute coronary syndrome and were treated with bare-metal stents more often than cancer-naive patients. Cancer survivors to cancer-naive patients' hazard ratio and 95% confidence interval were 1.46 (1.24-1.72), P value less than 0.001 for all-cause mortality and 1.41 (1.23-1.63), P value less than 0.001 for the composite of death, nonfatal myocardial infarction, target vessel revascularization, and coronary bypass surgery. Cardiac death was the leading cause of mortality in our hospital during follow-up in both groups, although more cancer survivors died of malignancy (25 vs. 5%, P<0.001).


CONCLUSIONS
Cancer survivors constitute a high proportion of the PCI population (one in every 13 patients) and have an ∼40% increased risk for cardiovascular morbidity and death. Cardiac disease was a leading cause of in-hospital mortality among these patients.
Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel.
Uri
U
Landes
Ran
R
Kornowski
Tamir
T
Bental
Abid
A
Assali
Hana
H
Vaknin-Assa
Eli
E
Lev
Zaza
Z
Iakobishvili
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
D008670:Metals