Outcome of current and history of cancer on the risk of cardiovascular events following percutaneous coronary intervention: a Kumamoto University Malignancy and Atherosclerosis (KUMA) study

• Published in: European heart journal. Quality of care & clinical outcomes 2018-10, Vol.4 (4), p.290-300
• Main Authors: Tabata, Noriaki, Sueta, Daisuke, Yamamoto, Eiichiro, Takashio, Seiji, Arima, Yuichiro, Araki, Satoshi, Yamanaga, Kenshi, Ishii, Masanobu, Sakamoto, Kenji, Kanazawa, Hisanori, Fujisue, Koichiro, Hanatani, Shinsuke, Soejima, Hirofumi, Hokimoto, Seiji, Izumiya, Yasuhiro, Kojima, Sunao, Yamabe, Hiroshige, Kaikita, Koichi, Tsujita, Kenichi
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Atherosclerosis; Cancer therapies; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - surgery; Clinical outcomes; Combined Modality Therapy; Comorbidity; Female; Health risk assessment; Humans; Incidence; Japan - epidemiology; Male; Middle Aged; Neoplasms - complications; Neoplasms - epidemiology; Neoplasms - therapy; Percutaneous Coronary Intervention; Postoperative Complications - epidemiology; Risk Assessment - methods; Survival Rate - trends
• ISSN: 2058-5225; 2058-1742
• DOI: 10.1093/ehjqcco/qcx047

With the advancement in successfully treating different types of cancers, there is an immediate and increased need to focus on the risk and complexity of treating cardiovascular events in cancer survivors. This has led to the emergence of onco-cardiology/cardio-oncology field. We examined the varying incidence of cardiovascular events after percutaneous coronary intervention (PCI) in patients with or without cancer. Participants were divided into a non-malignant group and a malignant group, consisting of patients who were receiving or had ever received cancer treatment. The primary endpoint was target lesion revascularization (TLR) within 1 year of PCI. In the patient groups studied, we showed that the malignant group had a significantly higher probability of TLR than the non-malignant group (P = 0.002). Moreover, proportional hazards analyses identified malignancy as an independent predictor of TLR [hazard ratio (HR) 2.28, 95% confidential interval (CI) 1.3-4.0; P = 0.004]. Combining malignancy status with high-sensitivity C-reactive protein levels further increased the HR for TLR (HR 3.01, 95% CI 1.57-5.76; P = 0.001), and the net reclassification improvement was significant (15.2%, 95% CI 4.3-26%; P = 0.02). Time since completion of cancer treatment had an impact on the rate of TLR, with those patients with a current or recent cancer history having more TLR events within 1 year. We demonstrated a significant association between the recent history of cancer and the risk of recurrent coronary atherosclerosis in patients undergoing PCI and showed that malignancy status can predict the likelihood of cardiovascular events following this procedure.