PARIS – Cancer survivors who subsequently undergo percutaneous coronary intervention are more likely to die of their cardiovascular disease than malignancy, Dr. Uri Landes reported at the annual congress of the European Association of Percutaneous Cardiovascular Interventions.
He presented a retrospective case-control study that included 969 patients who underwent PCI a mean of 3.6 years after being diagnosed with any form of cancer except nonmelanoma skin cancer and an equal number of PCI patients with no history of cancer. The two groups were matched for age, sex, left ventricular ejection fraction, estimated glomerular filtration rate, and diabetes and hypertension status.
In the patients with a history of cancer, 34% of in-hospital deaths were owing to cardiac causes, 25% to malignancy, and 24.5% to infection. In patients with no history of cancer, 42.5% of in-hospital deaths were cardiac, 5% were due to malignancy, and 33% were attributed to infection, according to Dr. Landes of Rabin Medical Center in Petah-Tikva, Israel.
During up to 10 years of follow-up, the all-cause mortality rate was 46% greater in patients with a prior cancer. Their risk of the composite endpoint of cardiac death or nonfatal MI was 40% greater than in controls without a history of cancer. Moreover, their risk of the composite outcome of cardiac death, MI, target vessel revascularization, and coronary artery bypass surgery was increased by 41% relative to that of PCI patients with no history of cancer.
The impetus for this study, Dr. Landes explained, is the dearth of information available on the long-term outcomes of PCI in patients with a history of cancer. The scarcity of information came about because cancer patients are typically excluded from participation in PCI clinical trials, and most PCI registries don’t include information as to whether or not a participant has a positive oncologic history.
Dr. Landes reported having no financial conflicts regarding this study, funded through Tel Aviv University.