Primary PCI equally effective in cancer patients with STEMI and those without cancer: Study
Delhi: Primary PCI is underused in cancer patients with active STEMI, despite it being associated with lower MACCE and in-hospital mortality just like in patients without cancer, reveals a recent study. The findings of the study are published in the European Heart Journal.
Primary percutaneous coronary intervention (pPCI) is thestandard of care for patients presenting with ST-elevation myocardial infarction (STEMI). However, the data on its use and effectiveness in cancer patients with active STEMI is limited. To fill this knowledge gap, Mamas A Mamas, Population Health Research Institute, Hamilton, Canada, and colleagues retrospectively analysed all STEMI hospitalizations between 2004 and 2015 from the National Inpatient Sample. They performed propensity score matching for estimating the average treatment effect of pPCI in each cancer on in-hospital adverse events, including major adverse cardiovascular and cerebrovascular events (MACCE) and its individual components.and compared treatment effect between cancer and non-cancer patients.
Key findings of the study include:
- Out of 1 870 815 patients with STEMI, 38 932 (2.1%) had a current cancer diagnosis [haematological: 11 251 (28.9% of all cancers); breast: 4675 (12.0%); lung: 9538 (24.5%); colon: 3749 (9.6%); prostate: 9719 (25.0%)].
- Patients with cancer received pPCI less commonly than those without cancer (from 54.2% for lung cancer to 70.6% for haematological vs. 82.3% in no cancer).
- Performance of pPCI was strongly associated with lower adjusted probabilities of MACCE and all-cause mortality in the cancer groups compared with the no cancer group.
- There was no significant difference in estimated average pPCI treatment effect between the cancer groups and non-cancer group.
"Primary PCI is underutilized in STEMI patients with current cancer despite its significantly lower associated rates of in-hospital all-cause mortality and MACCE that is comparable to patients without cancer. Further work is required to assess the long-term benefit and safety of pPCI in this high-risk group," wrote the authors.
The study titled, "Effect of primary percutaneous coronary intervention on in-hospital outcomes among active cancer patients presenting with ST-elevation myocardial infarction: a propensity score matching analysis," is published in the European Heart Journal.
