Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention.
Acute Coronary Syndrome
/ diagnostic imaging
Aged
Aged, 80 and over
Cause of Death
Coronary Artery Disease
/ diagnostic imaging
Female
Hospital Mortality
Humans
Male
Middle Aged
Neoplasms
/ diagnosis
Percutaneous Coronary Intervention
/ adverse effects
Risk Assessment
Risk Factors
Survivors
Time Factors
Treatment Outcome
Acute coronary syndrome
Cancer
Percutaneous coronary intervention
Prognosis
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
30 01 2020
30 01 2020
Historique:
received:
16
10
2019
accepted:
20
01
2020
entrez:
1
2
2020
pubmed:
1
2
2020
medline:
21
10
2020
Statut:
epublish
Résumé
Patients with cancer admitted for an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) represent a growing and high-risk population. The influence of co-existing cancer on mortality remains unclear in such patients. We aimed to assess the impact of cancer on early and late, all-cause and cardiac mortality in the setting of ACS and/or PCI. We performed a systematic review and meta-analysis of studies comparing outcomes of patients with and without a history of cancer admitted for ACS and/or PCI. Six studies including 294,528 ACS patients and three studies including 39,973 PCI patients were selected for our meta-analysis. Patients with cancer had increased rates of in-hospital all-cause death (RR 1.74 [1.22; 2.47]), cardiac death (RR 2.44 [1.73; 3.44]) and bleeding (RR 1.64 [1.35; 1.98]) as well as one-year all-cause death (RR 2.62 [1.2; 5.73]) and cardiac death (RR 1.89 [1.25; 2.86]) in ACS studies. Rates of long term all-cause (RR 1.96 [1.52; 2.53]) but not cardiac death were higher in cancer patients admitted for PCI. Cancer patients represent a high-risk population both in the acute phase and at long-term after an ACS or PCI. The magnitude of the risk of mortality should however be tempered by the heterogeneity among studies. Early and long term optimal management of such patients should be promoted in clinical practice.
Sections du résumé
BACKGROUND
Patients with cancer admitted for an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) represent a growing and high-risk population. The influence of co-existing cancer on mortality remains unclear in such patients. We aimed to assess the impact of cancer on early and late, all-cause and cardiac mortality in the setting of ACS and/or PCI.
METHODS
We performed a systematic review and meta-analysis of studies comparing outcomes of patients with and without a history of cancer admitted for ACS and/or PCI.
RESULTS
Six studies including 294,528 ACS patients and three studies including 39,973 PCI patients were selected for our meta-analysis. Patients with cancer had increased rates of in-hospital all-cause death (RR 1.74 [1.22; 2.47]), cardiac death (RR 2.44 [1.73; 3.44]) and bleeding (RR 1.64 [1.35; 1.98]) as well as one-year all-cause death (RR 2.62 [1.2; 5.73]) and cardiac death (RR 1.89 [1.25; 2.86]) in ACS studies. Rates of long term all-cause (RR 1.96 [1.52; 2.53]) but not cardiac death were higher in cancer patients admitted for PCI.
CONCLUSION
Cancer patients represent a high-risk population both in the acute phase and at long-term after an ACS or PCI. The magnitude of the risk of mortality should however be tempered by the heterogeneity among studies. Early and long term optimal management of such patients should be promoted in clinical practice.
Identifiants
pubmed: 32000685
doi: 10.1186/s12872-020-01352-0
pii: 10.1186/s12872-020-01352-0
pmc: PMC6993442
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
38Commentaires et corrections
Type : CommentIn
Références
Circulation. 2007 May 15;115(19):2570-89
pubmed: 17502591
Eur Heart J. 2018 Jan 7;39(2):119-177
pubmed: 28886621
CA Cancer J Clin. 2018 Jan;68(1):7-30
pubmed: 29313949
Am J Cardiol. 2016 Aug 1;118(3):345-52
pubmed: 27289296
J Am Heart Assoc. 2015 Jul 06;4(7):
pubmed: 26150477
Am J Cardiol. 2013 Nov 15;112(10):1533-9
pubmed: 23953696
Cancer. 2018 Mar 15;124(6):1269-1278
pubmed: 29211307
Lancet. 2016 Oct 8;388(10053):1459-1544
pubmed: 27733281
N Engl J Med. 2013 Mar 14;368(11):987-98
pubmed: 23484825
Am J Cardiovasc Drugs. 2017 Feb;17(1):61-71
pubmed: 27738920
Int J Cardiol. 2013 Sep 1;167(5):2335-7
pubmed: 23201078
Eur Heart J Acute Cardiovasc Care. 2018 Oct;7(7):631-638
pubmed: 28593789
JACC Cardiovasc Interv. 2012 Sep;5(9):893-902
pubmed: 22995875
Eur Heart J Acute Cardiovasc Care. 2018 Oct;7(7):639-645
pubmed: 28927294
Am J Cardiol. 2015 Jan 15;115(2):171-7
pubmed: 25465930
Cancer. 2016 May 1;122(9):1312-37
pubmed: 26959385
Arch Intern Med. 2003 Oct 27;163(19):2345-53
pubmed: 14581255
PLoS One. 2015 Feb 23;10(2):e0118777
pubmed: 25706944
Eur Heart J. 2003 Oct;24(20):1815-23
pubmed: 14563340
Crit Rev Oncol Hematol. 2004 Jun;50(3):187-96
pubmed: 15182825
N Engl J Med. 2009 Jan 8;360(2):150-9
pubmed: 19129528
J Am Coll Cardiol. 2006 Oct 3;48(7):1319-25
pubmed: 17010789
Coron Artery Dis. 2017 Jan;28(1):5-10
pubmed: 27622995
J Am Coll Cardiol. 2009 Apr 21;53(16):1399-409
pubmed: 19371823
J Am Coll Cardiol. 2009 Jun 16;53(24):2231-47
pubmed: 19520246
Eur Heart J Qual Care Clin Outcomes. 2018 Jul 1;4(3):200-207
pubmed: 29897437
Cancer Res. 1980 Apr;40(4):1217-22
pubmed: 7357551
Am J Cardiol. 2013 Dec 15;112(12):1867-72
pubmed: 24063839
J Am Coll Cardiol. 2015 Jun 30;65(25):2739-46
pubmed: 26112199
Oncology. 2005;68 Suppl 1:3-11
pubmed: 15855811
J Natl Cancer Inst. 2007 Mar 7;99(5):365-75
pubmed: 17341728
Mayo Clin Proc. 2016 Dec;91(12):1680-1692
pubmed: 27916154