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Other literature type . 2015
License: CC BY NC
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Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Authors: Hess, Connie N; Roe, Matthew T; Clare, Robert M; Chiswell, Karen; Kelly, Joseph; Tcheng, James E; Hagstrom, Emil; +6 Authors

Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Abstract

Background Cardiovascular 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 Results We 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). Conclusions Cancer 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.

Keywords

Male, Time Factors, percutaneous coronary intervention, Comorbidity, Coronary Artery Disease, Middle Aged, Risk Assessment, cardiovascular outcomes, Percutaneous Coronary Intervention, Treatment Outcome, Risk Factors, Case-Control Studies, Cause of Death, Neoplasms, North Carolina, cancer, Humans, Female, Stents, Registries, Original Research, Aged

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
64
Top 10%
Top 10%
Top 10%
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