Key result
History of cancer is linked to ~43% higher in-hospital mortality following PCI.
Why the study?
PCI in patients with active or prior history of cancer presents a challenge due to increased cardiovascular complications, motivating an evaluation of mortality and early and long-term adverse cardiovascular outcomes in this population.
Does an active or prior history of cancer increase mortality and adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
Meta-Analysis (n=8,446,204)
Yes
Does an active or prior history of cancer increase mortality and adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
Relative Risk: 1.43 (95% CI 1.03–1.99)
Absolute Risk Reduction: 1.2%
p-value: p=0.03
An active or prior history of cancer significantly increases the risk of early and long-term mortality, as well as bleeding events, in patients undergoing PCI, underscoring the need for careful multidisciplinary management.
Cancer history signals elevated post-PCI mortality and bleeding; extends observational evidence supporting cardio-oncology risk stratification.
The present illustration depicts the impact of active or prior history of cancer on clinical outcomes in patients undergoing percutaneous coronary intervention. The findings of this systematic review and meta -analysis of 18 studies encompassing more than 8 million patients suggest that cancer comorbidity is associated with higher mortality rates, in addition to major cardiovascular events in different time points. Notably, there was no difference in recurrent myocardial infarction rates between the two groups across all time points. • Cancer patients experience higher rates of all-cause and cardiovascular mortality after PCI. • Cancer patients demonstrate higher rates of bleeding, stroke, and heart failure after PCI. • Need for multidisciplinary approaches when managing cancer patients undergoing PCI. • Correct balance between thrombotic and bleeding risk can be challenging. Percutaneous coronary intervention (PCI) in patients with active or prior history of cancer presents a challenge due to the increased rates of cardiovascular complications. Therefore, we aimed to evaluate the mortality rates, in addition to early and long-term adverse cardiovascular outcomes in this high-risk population. A systematic literature search was conducted across PubMed, Cochrane, and Scopus databases to identify eligible studies comparing clinical outcomes between patients with active or prior history of cancer and patients without cancer. Our primary outcomes were all-cause mortality and cardiovascular mortality at different time points. Secondary outcomes included bleeding, stroke, recurrent myocardial infarction (MI), and heart failure events between the two groups. Overall, 18 studies with a total of 8 million patients were included. Active or prior history of cancer was associated with increased in-hospital all-cause mortality (RR: 1.43; 95 % CI: 1.03–1.99; p = 0.03), 1-year all-cause mortality (RR: 2.35; 95 % CI: 1.75–3.16; p < 0.001), as well as, increased 1-year cardiovascular mortality (RR: 1.35; 95 % CI: 1.15–1.59; p < 0.001) compared to patients without a history of cancer. Patients with active or prior history of cancer have higher rates of in-hospital (RR: 1.77; 95 % CI: 1.75–1.79; p < 0.001), 1-year (RR: 1.63; 95 %CI: 1.26–2.11; p < 0.001), and long-term bleeding events (RR: 2.08; 95 % CI: 1.30–3.35; p < 0.003) compared to patients without cancer. No significant differences were recorded regarding recurrent MI between the two groups. Active or prior history of cancer was associated with a negative impact on early and long-term clinical outcomes in patients undergoing PCI. These findings underline the importance of individualized and multidisciplinary approaches when treating this high-risk population.
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Vythoulkas-Biotis et al. (2025) conducted a meta-analysis in Active or prior history of cancer in patients undergoing percutaneous coronary intervention (PCI) (n=8,446,204). Active or prior history of cancer vs. No history of cancer was evaluated on In-hospital all-cause mortality (RR 1.43, 95% CI 1.03-1.99, p=0.03). Active or prior history of cancer was associated with increased in-hospital (RR 1.43) and 1-year (RR 2.35) all-cause mortality, as well as higher rates of bleeding and stroke following percutaneous coronary intervention.
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