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Relationship Between Cancer and Cardiovascular Outcomes Following Percutaneous Coronary Intervention
Duke Univ, Div Cardiol, Dept Med, Med Ctr, Durham, NC USA.;Duke Clin Res Inst, Durham, NC 27705 USA..
Duke Univ, Div Cardiol, Dept Med, Med Ctr, Durham, NC USA.;Duke Clin Res Inst, Durham, NC 27705 USA..
Duke Clin Res Inst, Durham, NC 27705 USA..
Duke Clin Res Inst, Durham, NC 27705 USA..
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2015 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 4, no 7, e001779Article in journal (Refereed) Published
Abstract [en]

Background-Cardiovascular disease and cancer increasingly coexist, yet relationships between cancer and long-term cardiovascular outcomes post-percutaneous coronary intervention (PCI) are not well studied. Methods and Results-We examined stented PCI patients at Duke (1996-2010) using linked data from the Duke Information Systems for Cardiovascular Care and the Duke Tumor Registry (a cancer treatment registry). Our primary outcome was cardiovascular mortality. Secondary outcomes included composite cardiovascular mortality, myocardial infarction, or repeat revascularization and all-cause mortality. We used adjusted cause-specific hazard models to examine outcomes among cancer patients (cancer treatment pre-PCI) versus controls (no cancer treatment pre-PCI). Cardiovascular mortality was explored in a cancer subgroup with recent (within 1 year pre-PCI) cancer and in post-PCI cancer patients using post-PCI cancer as a time-dependent variable. Among 15 008 patients, 3.3% (n=496) were cancer patients. Observed rates of 14-year cardiovascular mortality (31.4% versus 27.7%, P=0.31) and composite cardiovascular death, myocardial infarction, or revascularization (51.1% versus 55.8%, P=0.37) were similar for cancer versus control groups; all-cause mortality rates were higher (79.7% versus 49.3%, P<0.01). Adjusted risk of cardiovascular mortality was similar for cancer patients versus controls (hazard ratio 0.95; 95% CI 0.76 to 1.20) and for patients with versus without recent cancer (hazard ratio 1.46; 95% CI 0.92 to 2.33). Post-PCI cancer, present in 4.3% (n=647) of patients, was associated with cardiovascular mortality (adjusted hazard ratio 1.51; 95% CI 1.11 to 2.03). Conclusions-Cancer history was present in a minority of PCI patients but was not associated with worse long-term cardiovascular outcomes. Further investigation into PCI outcomes in this population is warranted.

Place, publisher, year, edition, pages
2015. Vol. 4, no 7, e001779
Keyword [en]
cancer, cardiovascular outcomes, percutaneous coronary intervention
National Category
Cancer and Oncology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-264678DOI: 10.1161/JAHA.115.001779ISI: 000361489400010OAI: oai:DiVA.org:uu-264678DiVA: diva2:861289
Funder
NIH (National Institute of Health), 5T32HL069749-09
Available from: 2015-10-16 Created: 2015-10-15 Last updated: 2017-12-01Bibliographically approved

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Hagström, EmilJames, Stefan K.

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