Original scientific paper
https://doi.org/10.3325/cmj.2024.65.405
Outcomes of 1.3 million patients undergoing percutaneous coronary intervention according to the presence of cancer and atrial fibrillation: a retrospective study
Sedralmontaha Istanbuly
; Faculty of Medicine, University of Aleppo, Aleppo, Syria
Andrija Matetić
; Department of Cardiology, University Hospital of Split, Split, Croatia
Vijay Bang
; Lilavati Hospital and Research Center, Mumbai, India
Kamal Sharma
; U.N. Mehta ICRC, B. J. Medical College, Ahmedebad, India
Harsh Golwala
; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
Babikir Kheir
; Section of Cardiac Electrophysiology, University of California San Francisco, San Francisco, CA
Mohammed Osman
; Section of Cardiovascular Medicine, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
Pooja Swamy
; Division of Cardiology, Loma Linda University, Loma Linda, CA
Aditya Bharadwaj
; Division of Cardiology, Loma Linda University, Loma Linda, CA
Mamas Mamas
; Keele Cardiovascular Research Group, Keele University, Newcastle, United Kingdom
*
* Corresponding author.
Abstract
Aim To evaluate outcomes after percutaneous coronary
intervention (PCI) in patients with cancer and atrial fibril
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lation (AF).
Methods Data of all adult discharges undergoing PCI be
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tween October 2015 and December 2018 were obtained
from the National Inpatient Sample (NIS) database. Adjust
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ed odds ratios (aOR) of adverse complications were calcu
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lated using binominal logistic regression.
Results 1 387 320 patients were detected, out of which
15.4% had AF but no cancer, 1.9% had cancer but no AF,
and 0.6% had both cancer and AF. Compared with cancer
patients without AF, those with AF had a greater aOR of
mortality (aOR 1.20, 95%CI 1.08-1.33), major adverse car
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diac and cerebrovascular events (MACCE) (aOR 1.18, 95%CI
1.07-1.29), and bleeding (aOR 1.23, 95%CI 1.08-1.39). How
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ever, the risk of ischemic stroke was similar between the
two groups. Patients with solid cancer and AF had a higher
aOR for all outcomes, including mortality (aOR 1.28, 95%CI
1.09-1.50), MACCE (aOR 1.37, 95%CI 1.19-1.57), ischemic
stroke (aOR 1.48, 95%CI 1.10-1.99), and bleeding (aOR 1.66,
95%CI 1.39-1.98) compared with the solid cancer group
without AF. In patients with hematological cancer, AF was
associated only with significantly increased risk of mortali
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ty (aOR 1.40, 95%CI 1.16-1.70) and MACCE (aOR 1.26, 95%CI
1.06-1.49).
Conclusions The presence of AF in solid cancer patients
increases the risk of mortality, MACCE, stroke, and major
bleeding, while in the setting of hematological cancer it is
only associated with a higher risk of mortality and MACCE.
Keywords
Hrčak ID:
336484
URI
Publication date:
15.10.2024.
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