Does a cancer diagnosis worsen outcomes after a heart procedure?

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A recent study investigated whether a cancer diagnosis was associated with worsened clinical outcomes in patients undergoing a heart procedure.

While ongoing diagnostic and therapeutic advances have improved survival rates in cancer and cardiovascular disease patients, the prevalence of these complications remain quite high. In recent years, researchers have shown that chemotherapy against cancer can increase the risk of cardiovascular complications, including angina, heart attacks, and worsening of coronary artery disease. These findings have resulted in several studies that have investigated the relationship between cancer and cardiac disease.

In a study published in the European Heart Journal, Potts and colleagues investigated the association between a cancer diagnosis and health outcomes in patients undergoing percutaneous coronary intervention (PCI). PCI is a non-surgical heart procedure where clinicians utilize a catheter to insert a stent in order to open narrowed blood vessels. In the current study, data from 6,571,034 PCI procedures undertaken between 2004 and 2014 were analyzed. Specifically, following PCI, patients were monitored for several in-hospital outcomes including mortality, cardiac complications, post-operative stroke, bleeding, and vascular complications.

The authors found that a current cancer diagnosis was associated with worsened clinical outcomes, compared to patients without any cancer history. Specifically, a current history of lung cancer was associated with increased in-hospital complications and mortality, whereas colon and prostate cancers were associated with increased in-hospital complications and bleeding, respectively. A current breast cancer diagnoses, however, was not associated with either in-hospital mortality or complications. Moreover, after adjustment for confounding factors, a historical diagnosis of lung cancer was also found to be associated with adverse outcomes.

The study showed that patients with cancer had worse clinical outcomes compared to a non-cancer patient undergoing PCI. The severity and type of clinical outcome, however, varied not only on the type of cancer but also on whether the cancer diagnosis was current or historical. Nonetheless, these findings suggest that additional care should be taken with cancer patients undergoing PCI in order to minimize the risk of complications.

Written by Haisam Shah, BSc

Reference: Potts, J. E., Iliescu, C. A., Lopez Mattei, J. C., Martinez, S. C., Holmvang, L., Ludman, P., … & Mamas, M. A. (2018). Percutaneous coronary intervention in cancer patients: a report of the prevalence and outcomes in the United States. European heart journal.

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