Key result
AF in cancer patients undergoing PCI is linked to ~20% higher mortality, MACCE, and bleeding.
Why the study?
Outcomes after PCI in patients with cancer and atrial fibrillation were not well characterized.
Does the presence of atrial fibrillation increase adverse outcomes in patients with cancer undergoing percutaneous coronary intervention?
Observational (n=1,387,320)
Yes
Does the presence of atrial fibrillation increase adverse outcomes in patients with cancer undergoing percutaneous coronary intervention?
The presence of atrial fibrillation in cancer patients undergoing PCI is associated with significantly increased risks of mortality, MACCE, and bleeding, particularly in those with solid tumors.
AF in cancer PCI patients was associated with higher mortality, MACCE, and bleeding; leaves open optimal antithrombotic strategies for prospective validation.
AIM: To evaluate outcomes after percutaneous coronary intervention (PCI) in patients with cancer and atrial fibrillation (AF). METHODS: Data of all adult discharges undergoing PCI between October 2015 and December 2018 were obtained from the National Inpatient Sample (NIS) database. Adjusted odds ratios (aOR) of adverse complications were calculated using binominal logistic regression. RESULTS: 1387320 patients were detected, out of which 15.4% had AF but no cancer, 1.9% had cancer but no AF, and 0.6% had both cancer and AF. Compared with cancer patients without AF, those with AF had a greater aOR of mortality (aOR 1.20, 95%CI 1.08-1.33), major adverse cardiac and cerebrovascular events (MACCE) (aOR 1.18, 95%CI 1.07-1.29), and bleeding (aOR 1.23, 95%CI 1.08-1.39). However, the risk of ischemic stroke was similar between the two groups. Patients with solid cancer and AF had a higher aOR for all outcomes, including mortality (aOR 1.28, 95%CI 1.09-1.50), MACCE (aOR 1.37, 95%CI 1.19-1.57), ischemic stroke (aOR 1.48, 95%CI 1.10-1.99), and bleeding (aOR 1.66, 95%CI 1.39-1.98) compared with the solid cancer group without AF. In patients with hematological cancer, AF was associated only with significantly increased risk of mortality (aOR 1.40, 95%CI 1.16-1.70) and MACCE (aOR 1.26, 95%CI 1.06-1.49). CONCLUSIONS: The presence of AF in solid cancer patients increases the risk of mortality, MACCE, stroke, and major bleeding, while in the setting of hematological cancer it is only associated with a higher risk of mortality and MACCE.
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Istanbuly et al. (2024) conducted an observational in Percutaneous coronary intervention in patients with cancer and atrial fibrillation (n=1,387,320). Atrial fibrillation vs. Cancer patients without atrial fibrillation was evaluated on Mortality (aOR 1.20, 95% CI 1.08-1.33). In cancer patients undergoing PCI, the presence of atrial fibrillation was associated with increased mortality (aOR 1.20; 95% CI 1.08-1.33), MACCE, and bleeding compared to those without AF.
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