Long Term Outcomes After Percutaneous Coronary Intervention in Patients With Lymphoma: A Propensity-Matched Analysis

Patients with a history of lymphoma may develop significant coronary artery disease (CAD), which may be treated by percutaneous coronary intervention (PCI), yet long term outcomes are not well characterized.

We reviewed patients with a history of lymphoma undergoing PCI from our institutional PCI database and compared characteristics and outcomes to a cohort without cancer. Long-term mortality and major adverse cardiac events (MACE) (cardiac death, myocardial infarction (MI), target vessel revascularization (TVR)) were assessed.

Of the 11,953 patients identified, 83 (0.7%) had past or current lymphoma. Most had Diffuse large B-cell lymphoma (DLBCL) (n=23; 28.8%) or Hodgkin's Lymphoma (HL) (n=22; 27.%), and 31 (37.3%) presented with acute coronary syndrome. Lymphoma patients, as compared to non-lymphoma patients, were similar with respect to age, sex, hypertension, diabetes, hyperlipidemia, prior MI, and prior PCI (all p=ns). The 1, 3, and 5-year survival rates were 90.5%, 69.5 %, and 52.5% in lymphoma patients as compared to 88.0%, 77.1%, and 66.7% in propensity matched non-lymphoma controls. Lymphoma was an independent predictor of mortality (OR 1.59; 95% CI 1.07-2.36, p=0.02) after multivariable adjustment. In propensity matched analysis over a median follow up of 4.2 years (IQR 1.28, 7.73), lymphoma was not independently associated with worse survival or MACE.

Among patients with CAD undergoing PCI, <1% had previous or active lymphoma. Although lymphoma may appear predictive of mortality in regression models with multivariable adjustment, mortality and MACE rates are similar to propensity matched controls.