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

Gong, Inna Y.; Yan, Andrew T.; Ko, Dennis T.; Earle, Craig C.; Cheung, Winson Y.; Peacock, Stuart; Hall, Marlous; Gale, Chris P; Chan, Kelvin K.

doi:10.1002/cncr.31174

Cited by 21 publications

(26 citation statements)

References 44 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%

“…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]. In one study [13] results were available in matched and unmatched groups: our principal meta-analysis was performed using the unmatched group as more endpoints were available and most included studies were not matched (the sensitivity analysis with the matched group of this study is reported in the Additional file 1).…”

Section: Resultsmentioning

confidence: 99%

“…The primary outcomes assessed by the study were allcause and cardiac in-hospital mortality. One study [8] reported 30-day mortality which was considered as early hence gathered with in-hospital mortality in the analysis. In-hospital bleeding, as defined in each study, was also included in the analysis.…”

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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