IN-HOSPITAL OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION WITH DRUG ELUTING STENTS IN PATIENTS WITH LOCALIZED AND METASTATIC CANCER: AN ANALYSIS OF THE NATIONAL INPATIENT SAMPLE.
Presenter
Juan Del Cid Fratti MD MS, MD MSc, The University of Washington, Peoria, IL
Juan Del Cid Fratti MD MS, MD MSc1, Miguel Salazar, MD2, Varun Vanka, MD3, Ezequiel Munoz, MD4 and Sudhir Mungee, M.D., FACC, FSCAI4, (1)The University of Washington, Peoria, IL, (2)Cleveland Clinic, Cleveland, OH, (3)OSF St. Francis Medical Center/UICOMP, Peoria, IL, IL, (4)University of Illinois College of Medicine at Peoria, Peoria, IL
Keywords: Acute Coronary Syndromes (ACS), Complications and Quality
Background
Patients with localized and advanced malignancy are usually excluded from RCT of drug-eluting stents (DES) and anti-platelet therapy. We aimed to evaluate short term outcomes of percutaneous coronary intervention (PCI) with DES in patients with localized and metastatic malignancy.
Methods
Analysis from the National inpatient sample 2016-2018 of patients with localized and advanced malignancy admitted for a PCI with DES. Primary outcome was in-hospital mortality. Secondary outcomes were post-procedural complications and healthcare-utilization. Multivariate regression analysis was performed to adjust for confounders.
Results
A total of weighted 1, 244, 550 PCI with DES were performed. 97.9 % in patients without cancer, 1.6% (n=21,125) patients with localized cancer and 0.3 % (n=4,765) with metastatic cancer. Patients with cancer were more likely to be males, older, whites, have higher comorbidity index, to have higher income, to use more Medicare, to be admitted to large hospitals. After multivariate regression analysis patients with localized malignancy did not have any difference in mortality or post-procedural complications. Patients with metastatic malignancy have higher in-hospital mortality, healthcare utilization cost and LOS, and need of blood products.
Conclusions
Patients with metastatic malignancy have higher in-hospital mortality when compared to patients without cancer most likely not related to procedure. Patients with localized or advanced malignancy do not have higher post-procedural complications. Blood transfusion is higher in patients with malignancy but is not related to post-procedural bleeding.
