Individuals undergoing PCI between 2004 and 2014 in the Nationwide Inpatient Sample were included in the study. Multivariable analyses were used to determine the association between
cancer diagnosis and in-hospital mortality and complications. 6 571 034 PCI procedures were included and current and previous
cancer rates were 1.8% and 5.8%, respectively. Both rates increased over time and the four most common
cancers were prostate, breast, colon, and
lung cancer. Patients with a current
lung cancer had greater in-hospital mortality (odds ratio (OR) 2.81, 95% confidence interval (95% CI) 2.37-3.34) and any in-hospital complication (OR 1.21, 95% CI 1.10-1.36), while current
colon cancer was associated with any complication (OR 2.17, 95% CI 1.90-2.48) and
bleeding (OR 3.65, 95% CI 3.07-4.35) but not mortality (OR 1.39, 95% CI 0.99-1.95). A current diagnosis of breast was not significantly associated with either in-hospital mortality or any of the complications studied and
prostate cancer was only associated with increased risk of
bleeding (OR 1.41, 95% CI 1.20-1.65). A historical diagnosis of
lung cancer was independently associated with an increased OR of in-hospital mortality (OR 1.65, 95% CI 1.32-2.05).
CONCLUSIONS:
Cancer among patients receiving PCI is common and the prognostic impact of
cancer is specific both for the type of
cancer, presence of
metastases and whether the diagnosis is historical or current. Treatment of patients with a
cancer diagnosis should be individualized and involve a close collaboration between cardiologists and oncologists.