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Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention

OBJECTIVES: The purpose of this study was to evaluate ischemic and bleeding outcomes of unselected cancer patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: The number of cancer patients undergoing PCI is increasing despite concerns regarding ischemic and bleeding risks. METHO...

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Autores principales: Ueki, Yasushi, Vögeli, Benjamin, Karagiannis, Alexios, Zanchin, Thomas, Zanchin, Christian, Rhyner, Daniel, Otsuka, Tatsuhiko, Praz, Fabien, Siontis, George C.M., Moro, Christina, Stortecky, Stefan, Billinger, Michael, Valgimigli, Marco, Pilgrim, Thomas, Windecker, Stephan, Suter, Thomas, Räber, Lorenz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352169/
https://www.ncbi.nlm.nih.gov/pubmed/34396175
http://dx.doi.org/10.1016/j.jaccao.2019.11.001
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author Ueki, Yasushi
Vögeli, Benjamin
Karagiannis, Alexios
Zanchin, Thomas
Zanchin, Christian
Rhyner, Daniel
Otsuka, Tatsuhiko
Praz, Fabien
Siontis, George C.M.
Moro, Christina
Stortecky, Stefan
Billinger, Michael
Valgimigli, Marco
Pilgrim, Thomas
Windecker, Stephan
Suter, Thomas
Räber, Lorenz
author_facet Ueki, Yasushi
Vögeli, Benjamin
Karagiannis, Alexios
Zanchin, Thomas
Zanchin, Christian
Rhyner, Daniel
Otsuka, Tatsuhiko
Praz, Fabien
Siontis, George C.M.
Moro, Christina
Stortecky, Stefan
Billinger, Michael
Valgimigli, Marco
Pilgrim, Thomas
Windecker, Stephan
Suter, Thomas
Räber, Lorenz
author_sort Ueki, Yasushi
collection PubMed
description OBJECTIVES: The purpose of this study was to evaluate ischemic and bleeding outcomes of unselected cancer patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: The number of cancer patients undergoing PCI is increasing despite concerns regarding ischemic and bleeding risks. METHODS: Between 2009 and 2017, consecutive patients undergoing PCI were prospectively included in the Bern PCI Registry. Cancer-specific data including type, date of initial diagnosis, and health status at index PCI were collected. We performed propensity score matching to adjust for baseline differences between patients with and without cancer. The primary ischemic endpoint was the device-oriented composite endpoint (cardiac death, target vessel myocardial infarction, target lesion revascularization) at 1 year, and the primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) 2 to 5 at 1 year. RESULTS: Among 13,647 patients, 1,368 (10.0%) had an established diagnosis of cancer. The 3 leading cancer types were prostate (n = 294), gastrointestinal tract (n = 188), and hematopoietic (n = 177). At index PCI, 179 (13.1%) patients were receiving active cancer treatment. In matched analysis, there was no significant difference in device-oriented composite endpoint (11.5% vs. 10.2%; p = 0.251), whereas cardiac death and BARC 2 to 5 bleeding occurred more frequently among patients with cancer compared with those without cancer (6.8% vs. 4.5%; p = 0.010 and 8.0% vs. 6.0%; p = 0.026, respectively). Cancer diagnosis within 1 year before PCI emerged as an independent predictor for cardiac death and BARC 2 to 5 bleeding at 1 year. CONCLUSIONS: Cancer patients carry an increased risk of cardiac mortality that was not associated with stent-related ischemic events among patients undergoing PCI in routine clinical practice. Higher risk of bleeding in cancer patients undergoing PCI deserves particular attention. (CARDIOBASE Bern PCI Registry; NCT02241291)
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spelling pubmed-83521692021-08-13 Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention Ueki, Yasushi Vögeli, Benjamin Karagiannis, Alexios Zanchin, Thomas Zanchin, Christian Rhyner, Daniel Otsuka, Tatsuhiko Praz, Fabien Siontis, George C.M. Moro, Christina Stortecky, Stefan Billinger, Michael Valgimigli, Marco Pilgrim, Thomas Windecker, Stephan Suter, Thomas Räber, Lorenz JACC CardioOncol Original Research OBJECTIVES: The purpose of this study was to evaluate ischemic and bleeding outcomes of unselected cancer patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: The number of cancer patients undergoing PCI is increasing despite concerns regarding ischemic and bleeding risks. METHODS: Between 2009 and 2017, consecutive patients undergoing PCI were prospectively included in the Bern PCI Registry. Cancer-specific data including type, date of initial diagnosis, and health status at index PCI were collected. We performed propensity score matching to adjust for baseline differences between patients with and without cancer. The primary ischemic endpoint was the device-oriented composite endpoint (cardiac death, target vessel myocardial infarction, target lesion revascularization) at 1 year, and the primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) 2 to 5 at 1 year. RESULTS: Among 13,647 patients, 1,368 (10.0%) had an established diagnosis of cancer. The 3 leading cancer types were prostate (n = 294), gastrointestinal tract (n = 188), and hematopoietic (n = 177). At index PCI, 179 (13.1%) patients were receiving active cancer treatment. In matched analysis, there was no significant difference in device-oriented composite endpoint (11.5% vs. 10.2%; p = 0.251), whereas cardiac death and BARC 2 to 5 bleeding occurred more frequently among patients with cancer compared with those without cancer (6.8% vs. 4.5%; p = 0.010 and 8.0% vs. 6.0%; p = 0.026, respectively). Cancer diagnosis within 1 year before PCI emerged as an independent predictor for cardiac death and BARC 2 to 5 bleeding at 1 year. CONCLUSIONS: Cancer patients carry an increased risk of cardiac mortality that was not associated with stent-related ischemic events among patients undergoing PCI in routine clinical practice. Higher risk of bleeding in cancer patients undergoing PCI deserves particular attention. (CARDIOBASE Bern PCI Registry; NCT02241291) Elsevier 2019-12-17 /pmc/articles/PMC8352169/ /pubmed/34396175 http://dx.doi.org/10.1016/j.jaccao.2019.11.001 Text en © 2019 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Ueki, Yasushi
Vögeli, Benjamin
Karagiannis, Alexios
Zanchin, Thomas
Zanchin, Christian
Rhyner, Daniel
Otsuka, Tatsuhiko
Praz, Fabien
Siontis, George C.M.
Moro, Christina
Stortecky, Stefan
Billinger, Michael
Valgimigli, Marco
Pilgrim, Thomas
Windecker, Stephan
Suter, Thomas
Räber, Lorenz
Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title_full Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title_fullStr Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title_full_unstemmed Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title_short Ischemia and Bleeding in Cancer Patients Undergoing Percutaneous Coronary Intervention
title_sort ischemia and bleeding in cancer patients undergoing percutaneous coronary intervention
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352169/
https://www.ncbi.nlm.nih.gov/pubmed/34396175
http://dx.doi.org/10.1016/j.jaccao.2019.11.001
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