Percutaneous coronary intervention in patients with cancer and readmissions within 90 days for acute myocardial infarction and bleeding in the USA

Author:

Kwok Chun Shing12ORCID,Wong Chun Wai1,Kontopantelis Evangelos3ORCID,Barac Ana4ORCID,Brown Sherry-Ann5ORCID,Velagapudi Poonam6ORCID,Hilliard Anthony A7,Bharadwaj Aditya S7,Chadi Alraies M8,Mohamed Mohamed12ORCID,Bhatt Deepak L9ORCID,Mamas Mamas A12ORCID

Affiliation:

1. Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK

2. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK

3. Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK

4. Department of Cardiology, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC, USA

5. Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

6. Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA

7. Department of Medicine, Division of Cardiology, Linda University School of Medicine, Loma Linda, CA, USA

8. Department of Cardiology, Wayne State University, Detroit Medical Center, Detroit Heart Hospital, MI, USA

9. Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA

Abstract

Abstract Aims The post-discharge outcomes of patients with cancer who undergo PCI are not well understood. This study evaluates the rates of readmissions within 90 days for acute myocardial infarction (AMI) and bleeding among patients with cancer who undergo percutaneous coronary intervention (PCI). Methods and results Patients treated with PCI in the years from 2010 to 2014 in the US Nationwide Readmission Database were evaluated for the influence of cancer on 90-day readmissions for AMI and bleeding. A total of 1 933 324 patients were included in the analysis (2.7% active cancer, 6.8% previous history of cancer). The 90-day readmission for AMI after PCI was higher in patients with active cancer (12.1% in lung, 10.8% in colon, 7.5% in breast, 7.0% in prostate, and 9.1% for all cancers) compared to 5.6% among patients with no cancer. The 90-day readmission for bleeding after PCI was higher in patients with active cancer (4.2% in colon, 1.5% in lung, 1.4% in prostate, 0.6% in breast, and 1.6% in all cancer) compared to 0.6% among patients with no cancer. The average time to AMI readmission ranged from 26.7 days for lung cancer to 30.5 days in colon cancer, while the average time to bleeding readmission had a higher range from 38.2 days in colon cancer to 42.7 days in breast cancer. Conclusions Following PCI, patients with cancer have increased risk for readmissions for AMI or bleeding, with the magnitude of risk depending on both cancer type and the presence of metastasis.

Funder

Royal Stoke Hospital

Biosensors International

Elsevier Practice Update Cardiology

Medscape Cardiology

PhaseBio

Regado Biosciences

Board of Directors

Boston VA Research Institute

Society of Cardiovascular Patient Care

TobeSoft

American Heart Association Quality Oversight Committee

Data Monitoring Committees

Duke Clinical Research Institute

Mayo Clinic

Mount Sinai School of Medicine

Population Health Research Institute

Honoraria: American College of Cardiology

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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