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Published on: October 14, 2016
Outcomes for Cancer Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous
Joshua A Jacobs1, Kerry Pickworth1, Konstantinos Dean Boudoulas2
1The Richard M. Ross Heart Hospital, The Ohio State University Wexner Medical Center, United States of America.
Insights
Cancer patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) have similar in-hospital complication rates. However, cancer survivors are more likely to be readmitted within 30 days.
Area of Science:
- Cardiology
- Oncology
- Interventional Cardiology
Background:
- Cardiovascular disease incidence is increasing in cancer patients.
- The risk of in-hospital complications for cancer patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is not well-defined.
Purpose of the Study:
- To evaluate the risk of in-hospital complications in cancer patients undergoing primary PCI for STEMI.
- To compare complication rates between cancer patients and non-cancer patients receiving primary PCI for STEMI.
Main Methods:
- Retrospective single-center cohort study.
- Inclusion of 58 cancer patients and 551 non-cancer patients who underwent primary PCI for STEMI between 2012 and 2017.
- Primary outcome was a composite of in-hospital complications, including mortality, reinfarction, shock, heart failure, stroke, arrhythmias, bleeding, and need for dialysis or mechanical support.
Main Results:
- Overall in-hospital complications occurred in 37.6% of patients.
- No significant difference in overall in-hospital complications between cancer patients (39.7%) and non-cancer patients (37.4%).
- Cancer patients had higher rates of 30-day readmission (12.7% vs. 5%) and received bare metal stents more frequently (50% vs. 30.4%).
Conclusions:
- Primary PCI for STEMI in cancer patients is associated with similar in-hospital complication rates compared to non-cancer patients.
- Cancer patients undergoing primary PCI for STEMI face increased risk of 30-day readmission.
- Further research is needed to understand the factors contributing to higher readmission rates in cancer survivors.
Background/Purpose:
The incidence of cardiovascular disease in cancer patients is rising. The risk of in-hospital complications for cancer patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is not well defined.
Methods/Materials:
A retrospective single-center cohort assessing STEMI patients with a history of cancer (n = 58) and without a history of cancer (n = 551) who underwent primary PCI between January 1, 2012 and June 30, 2017 was conducted. The primary outcome was a composite of in-hospital complications including reinfarction, cardiogenic shock, new heart failure, stroke, new atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, bleeding, new dialysis requirement, mechanical circulatory support, hospice requirement, and in-hospital mortality.
Results:
Overall in-hospital complications occurred in 229 (37.6%) patients. There was no significant difference in overall complications in patients with a history of cancer (39.7%), compared to those without a cancer history (37.4%) (adjusted OR 0.84 [0.46-1.51], p = 0.58; unadjusted OR 1.10 [0.61-1.92], p = 0.73); there were no differences exhibited in any of the individual complications. Patients with a history of cancer were significantly more likely to be readmitted within 30 days (12.7% vs. 5%; p = 0.03) and receive bare metal stents (50% vs. 30.4%; p = 0.004) as compared to patients without a history of cancer.
Conclusions:
There was no significant difference for in-hospital complications in patients with a history of cancer and those without a history of cancer undergoing primary PCI for STEMI. Patients with a history of cancer were more likely to readmitted within 30 days and receive bare metal stents.
Summary:
The risk of in-hospital complications for cancer patients with STEMI undergoing primary PCI is not well defined. In a single-center retrospective cohort, there was no significant difference for in-hospital complications between patients with a history of cancer and those without a history of cancer undergoing primary PCI for STEMI.
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