Cancer patients experience much worse outcomes—including higher rates of all-cause mortality, myocardial infarction (MI) and stent thrombosis—after percutaneous coronary intervention (PCI), according to new findings published in JACC: Cardiovascular Interventions.
The team behind the study explored data from nearly 1,200 patients who underwent PCI from 2003 to 2013. While 416 patients had cancer at the time of the procedure, another 768 patients did not. All data came from the Mayo Clinic Cath Lab PCI Registry, and the study’s primary endpoint was a combination of all-cause mortality, myocardial infarction (MI) and repeat revascularization after five years.
Overall, that combined primary endpoint occurred in 48.6% of patients with cancer and 33% of patients without cancer. Also, cancer patients had a higher rate of noncardiac death (24% vs 10.5%)—but a lower rate of cardiac death (5% vs. 11.7%).
Looking closer at the data, cancer patients had much higher rates of MI (16.1% vs. 8%), stent thrombosis (6% vs. 2.3%), repeat revascularization (21.2% vs. 10%), bleeding events (6.7% vs. 3.9%), five-year major adverse cardiovascular events (48.6% vs. 33%) and all-cause mortality (29.1% vs. 22.3%). The risk of stent thrombosis, the authors added, appeared to only be noticeable for the first year after PCI.
One key finding from the group’s analysis was that dual antiplatelet therapy (DAPT) scores may be a helpful tool for identifying patients at an especially high ischemic or thrombotic risk.
“These findings emphasize the importance of adequate DAPT in cancer patients, especially those with a high DAPT score, and support the design of a prospective randomized controlled trial to define optimal type and duration of DAPT in cancer patients after PCI,” wrote lead author Wei Guo, MD, PhD, Peking University People’s Hospital in China, and colleagues.
Read the full study here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.