Outcomes of 1.3 million patients undergoing percutaneous coronary intervention according to the presence of cancer and atrial fibrillation: a retrospective study.

Istanbuly, Sedralmontaha; Matetić, Andrija; Bang, Vijay; Sharma, Kamal; Golwala, Harsh; Kheiri, Babikir; Osman, Mohammed; Swamy, Pooja; Bharadwaj, Aditya; Mamas, Mamas A

Abstract

To evaluate outcomes after percutaneous coronary intervention (PCI) in patients with cancer and atrial fibrillation (AF). Data of all adult discharges undergoing PCI between October 2015 and December 2018 were obtained from the National Inpatient Sample (NIS) database. Adjusted odds ratios (aOR) of adverse complications were calculated using binominal logistic regression. 1387320 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 cardiac and cerebrovascular events (MACCE) (aOR 1.18, 95%CI 1.07-1.29), and bleeding (aOR 1.23, 95%CI 1.08-1.39). However, 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 mortality (aOR 1.40, 95%CI 1.16-1.70) and MACCE (aOR 1.26, 95%CI 1.06-1.49). 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.

Citation

Istanbuly, S., Matetić, A., Bang, V., Sharma, K., Golwala, H., Kheiri, B., Osman, M., Swamy, P., Bharadwaj, A., & Mamas, M. A. (2024). Outcomes of 1.3 million patients undergoing percutaneous coronary intervention according to the presence of cancer and atrial fibrillation: a retrospective study. Croatian Medical Journal, 65(5), 405-416

• Journal Article Type: Article
• Acceptance Date: Sep 11, 2024
• Online Publication Date: Oct 31, 2024
• Publication Date: Oct 31, 2024
• Deposit Date: Nov 28, 2024
• Journal: Croatian medical journal
• Print ISSN: 0353-9504
• Electronic ISSN: 1332-8166
• Publisher: School of Medicine
• Peer Reviewed: Peer Reviewed
• Volume: 65
• Issue: 5
• Pages: 405-416
• Keywords: Treatment Outcome, Adult, Postoperative Complications - epidemiology - etiology, Middle Aged, Aged, Male, Humans, Female, Retrospective Studies, Aged, 80 and over, Hemorrhage - epidemiology - etiology, Percutaneous Coronary Intervention - adverse effects, Neoplasms - epidemiology, Risk Factors, Atrial Fibrillation - epidemiology
• Public URL: https://keele-repository.worktribe.com/output/980952
• Publisher URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC11568383/