Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy

Iannaccone, Mario; D’Ascenzo, Fabrizio; Vadalà, Paolo; Wilton, Stephen B.; Noussan, Patrizia; Colombo, Francesco; Roubín, Sergio Raposeiras; Assi, Emad Abu; González-Juanatey, José Ramón; Henriques, José P.S.; Saucedo, Jorge; Kikkert, Wouter J.; Núñez‐Gil, Iván J.; Arizá-Solé, Albert; Song, Xiaoyan; Alexopoulos, Dimitrios; Liebetrau, Christoph; Kawaji, Tetsuma; Moretti, Claudio; Garbo, Roberto; Huczek, Zenon; Nie, Shaoping; Fujii, Toshiharu; Correia, Luís Cláudio Lemos; Kawashiri, Masa‐aki; Acuña, José María García; Southern, Danielle; Alfonso, Emilio; Terol, Belén; Garay, Alberto; Zhang, Dongfeng; Chen, Yalei; Xanthopoulou, Ioanna; Osman, Neriman; Möllmann, Helge; Shiomi, Hiroki; Giordana, Francesca; Kowara, Michał; Filipiak‬, Krzysztof J.; Wang, Xiao; Yan, Yan; Fan, Jingyao; Ikari, Yuji; Nakahashi, Takuya; Sakata, Kenji; Gaïta, Fiorenzo; Yamagishi, Masakazu; Kalpak, Oliver; Kedev, Saško

doi:10.1177/2048872617706501

Cited by 91 publications

(77 citation statements)

References 35 publications

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“…The heterogeneity among studies may be explained by the differences in sample size and statistical methods. Additionally, the small increase of all-cause death in cancer patients observed (7) n/a n/a n/a n/a n/a n/a [8,9,11,12], compared to non-cancer patients. These conditions are associated with poor prognosis in ACS patients [17][18][19][20].…”

Section: Discussionmentioning

confidence: 92%

“…A total of 9 studies were selected for the meta-analysis: 6 studies [8][9][10][11][12][13] in the setting of ACS and 3 studies [14][15][16] in the setting of PCI (elective or for ACS), including 294,528 and 39,973 patients respectively. The review process is depicted in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…1. Most studies were registries [9,[11][12][13][14]16], one was obtained from databases [8] and the two remaining from retrospective cohorts [10,15]. Two studies reported only pair-matched comparison results [11,15] and two others used propensity scores [8,14].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover malignancy is associated with the risk of stent thrombosis [23]. Finally, patients with cancer are less likely to receive optimal guideline recommended medications [9,11,24]. The use of early invasive strategy, and PCI if needed, is associated with improved outcome after ACS [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…The use of early invasive strategy, and PCI if needed, is associated with improved outcome after ACS [25,26]. A less frequent use of PCI or drug eluting stents in patients with a history of cancer admitted for ACS has been reported [9,11,12] but current data remain conflicting [8]. A recent study reported that optimal medical therapy was prescribed in only one third of cancer patients at discharge [27].…”

Section: Discussionmentioning

confidence: 99%

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Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention

Roule

Verdier

Blanchart

et al. 2020

BMC Cardiovasc Disord

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Background: Patients with cancer admitted for an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) represent a growing and high-risk population. The influence of co-existing cancer on mortality remains unclear in such patients. We aimed to assess the impact of cancer on early and late, all-cause and cardiac mortality in the setting of ACS and/or PCI. Methods: We performed a systematic review and meta-analysis of studies comparing outcomes of patients with and without a history of cancer admitted for ACS and/or PCI. Results: Six studies including 294,528 ACS patients and three studies including 39,973 PCI patients were selected for our meta-analysis. Patients with cancer had increased rates of in-hospital all-cause death (RR 1.74 [1.22; 2.47]), cardiac death (RR 2.44 [1.73; 3.44]) and bleeding (RR 1.64 [1.35; 1.98]) as well as one-year all-cause death (RR 2.62 [1.2; 5.73]) and cardiac death (RR 1.89 [1.25; 2.86]) in ACS studies. Rates of long term all-cause (RR 1.96 [1.52; 2.53])but not cardiac death were higher in cancer patients admitted for PCI. Conclusion: Cancer patients represent a high-risk population both in the acute phase and at long-term after an ACS or PCI. The magnitude of the risk of mortality should however be tempered by the heterogeneity among studies. Early and long term optimal management of such patients should be promoted in clinical practice.

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Section: Discussionmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention

Roule

Verdier

Blanchart

et al. 2020

BMC Cardiovasc Disord

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Proportion and number of incident cancer deaths in coronary artery disease

Liu,

Chen,

Zhou

et al. 2023

Cancer Medicine

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BackgroundGlobally, coronary artery disease (CAD) and cancer are the leading causes of death. Studies focusing on the proportion and spectrum of cancer mortality among CAD patients are lacking. We aim to characterize the proportion and spectrum of cancer‐specific mortality among patients with CAD.MethodsWe analyzed 93,797 hospitalized survivors with angiographically documented CAD between 2007 and 2020 (mean age: 62.8 ± 11.1 years, 24.7% female) from Cardiorenal ImprovemeNt II (CIN‐II) cohort.ResultsDuring the median follow‐up of 4.8 years (IQR: 2.6–7.5), 13,162 (14.0%) patients died after discharge. A total of 1223/7703 (15.8% of cause‐specific death) CAD patients died of cancer. The three most common types of cancer‐specific death were lung (36.1%), liver (13.3%), and colorectum cancer (12.8%). Furthermore, male (adjusted HR 2.38, 95% CI: 1.99–2.85) and older (≥60 vs. <60 years, adjusted HR 3.25, 95%CI 2.72–3.88) patients had a significantly increased cancer‐specific mortality.ConclusionsOur data suggest that nearly one‐sixth of death is accounted for cancer among CAD patients within a median follow‐up of 4.8 years. Lung, liver, and colorectum cancer are top three cancer‐specific mortality. Further studies are needed to reduce cancer mortality for CAD patients, especially in older and male ones.Trail Registration(ClinicalTrials.gov NCT05050877).

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Acute Coronary Syndrome, Thrombocytopenia, and Antiplatelet Therapy in Critically Ill Cancer Patients

Donisan¹,

Balanescu²,

Iliescu³

et al. 2019

Oncologic Critical Care

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Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy

Cited by 91 publications

References 35 publications

Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention

Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention

Proportion and number of incident cancer deaths in coronary artery disease

Acute Coronary Syndrome, Thrombocytopenia, and Antiplatelet Therapy in Critically Ill Cancer Patients

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