Primary PCI effective but underutilized in patients with STEMI, cancer
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Primary PCI was associated with positive outcomes in patients with STEMI and cancer, but was underutilized, according to study data published in European Heart Journal: Acute Cardiovascular Care.
“Although primary PCI has become the standard of care for STEMI presentations, there are limited data on whether cancer patients are as likely to be offered the intervention as those without cancer,” Mohamed O. Mohamed, MBBCh, MRCP(UK), academic cardiology registrar at Keele Cardiovascular Research Group, Keele University, U.K., and colleagues wrote.
In a retrospective study, researchers analyzed 1,870,815 STEMI hospitalizations (97.9% with no current cancer diagnosis) and performed propensity-score matching to estimate the average treatment effect of primary PCI stratified by cancer type. Cancer types in the cohort included hematological, breast, lung, colon and prostate.
According to the researchers, patients without cancer received primary PCI for STEMI more often than patients with a current cancer diagnosis (no cancer, 82.3%; range across cancer types, 54.2% to 70.6%).
Researchers noted primary PCI effectiveness was at least equal to or greater in patients with cancer compared with patients without cancer. In patients without cancer and in patients in all five of the cancer categories, those who underwent PCI had less risk for mortality or major adverse CV and cerebrovascular events compared with those who did not (P .01 for all).
“The results indicate that heart attack patients should receive primary PCI regardless of whether or not they have cancer. Some patients with cancer are at elevated risk of bleeding and it was reassuring that the intervention did not result in an increased risk of bleeding events,” Mohamed said in a press release. “Our study assessed in-hospital outcomes, which are important landmarks, but longer-term follow-up is needed in this high-risk and yet understudied population.”
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