Key result
Active cancer is consistently linked to increased post-PCI bleeding risk across observational studies.
Why the study?
Cancer activity may modify bleeding and ischemic risk after PCI, but available reports differ in cancer definitions, antiplatelet exposure, and follow-up.
Does cancer activity (active cancer, recent diagnosis, or ongoing therapy) modify bleeding and ischemic risk after percutaneous coronary intervention?
Systematic Review
Does cancer activity (active cancer, recent diagnosis, or ongoing therapy) modify bleeding and ischemic risk after percutaneous coronary intervention?
This systematic review demonstrates that while active cancer is frequently associated with post-PCI bleeding, current observational evidence is too heterogeneous to establish a cancer-specific DAPT duration or preferred P2Y12 inhibitor.
Active cancer heightens post-PCI bleeding risk; leaves open optimal DAPT duration and P2Y12 selection.
Cancer activity may modify bleeding and ischemic risk after percutaneous coronary intervention (PCI), but available reports differ in cancer definitions, antiplatelet exposure and follow-up. We reassessed a PROSPERO-registered systematic review (CRD420261350515), originally comprising five observational studies, and undertook targeted verification of related primary literature. Five further potentially eligible reports were identified, providing ten source-verified reports for an expanded, non-exhaustive evidence audit. Active cancer, recent diagnosis or ongoing therapy were frequently associated with bleeding, although ischemic findings were less consistent. One large Veterans Affairs cohort examined observational associations between dual antiplatetet therapy (DAPT) discontinuation and longer-term outcomes by cancer activity; this was not a randomized strategy comparison. Definitions and follow-up precluded pooling of activity-specific bleeding risk ratios. The evidence does not establish a cancer-specific DAPT duration or preferred P2Y12 inhibitor. Prospective studies should integrate serial oncologic, hematologic, procedural and antiplatelet information.
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Νικολαϊδου et al. (2026) conducted a systematic review in Cancer and percutaneous coronary intervention (PCI). Active cancer, recent diagnosis, or ongoing therapy vs. Inactive/remission cancer or no cancer was evaluated on Bleeding and ischemic events. Active cancer, recent diagnosis, or ongoing therapy was frequently associated with bleeding across 10 observational PCI studies, though heterogeneity precluded pooling of risk ratios.
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