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美国癌症患者经皮冠状动脉介入治疗后 90 天内因急性心肌梗死和出血再入院的情况。

Percutaneous coronary intervention in patients with cancer and readmissions within 90 days for acute myocardial infarction and bleeding in the USA.

机构信息

Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.

Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK.

出版信息

Eur Heart J. 2021 Mar 7;42(10):1019-1034. doi: 10.1093/eurheartj/ehaa1032.

Abstract

AIMS

The post-discharge outcomes of patients with cancer who undergo PCI are not well understood. This study evaluates the rates of readmissions within 90 days for acute myocardial infarction (AMI) and bleeding among patients with cancer who undergo percutaneous coronary intervention (PCI).

METHODS AND RESULTS

Patients treated with PCI in the years from 2010 to 2014 in the US Nationwide Readmission Database were evaluated for the influence of cancer on 90-day readmissions for AMI and bleeding. A total of 1 933 324 patients were included in the analysis (2.7% active cancer, 6.8% previous history of cancer). The 90-day readmission for AMI after PCI was higher in patients with active cancer (12.1% in lung, 10.8% in colon, 7.5% in breast, 7.0% in prostate, and 9.1% for all cancers) compared to 5.6% among patients with no cancer. The 90-day readmission for bleeding after PCI was higher in patients with active cancer (4.2% in colon, 1.5% in lung, 1.4% in prostate, 0.6% in breast, and 1.6% in all cancer) compared to 0.6% among patients with no cancer. The average time to AMI readmission ranged from 26.7 days for lung cancer to 30.5 days in colon cancer, while the average time to bleeding readmission had a higher range from 38.2 days in colon cancer to 42.7 days in breast cancer.

CONCLUSIONS

Following PCI, patients with cancer have increased risk for readmissions for AMI or bleeding, with the magnitude of risk depending on both cancer type and the presence of metastasis.

摘要

目的

接受经皮冠状动脉介入治疗(PCI)的癌症患者出院后的结局尚不清楚。本研究评估了癌症患者 PCI 后 90 天内因急性心肌梗死(AMI)和出血再入院的发生率。

方法和结果

在美国全国再入院数据库中,2010 年至 2014 年接受 PCI 治疗的患者接受了评估,以研究癌症对 PCI 后 90 天内 AMI 和出血再入院的影响。共纳入 1933324 例患者(2.7%为活动性癌症,6.8%为既往癌症病史)。与无癌症患者(5.6%)相比,活动性癌症患者 PCI 后 90 天内因 AMI 再入院的比例更高(肺癌为 12.1%,结肠癌为 10.8%,乳腺癌为 7.5%,前列腺癌为 7.0%,所有癌症为 9.1%)。与无癌症患者(0.6%)相比,活动性癌症患者 PCI 后 90 天内因出血再入院的比例更高(结肠癌为 4.2%,肺癌为 1.5%,前列腺癌为 1.4%,乳腺癌为 0.6%,所有癌症为 1.6%)。因 AMI 再入院的平均时间范围为 26.7 天(肺癌)至 30.5 天(结肠癌),因出血再入院的平均时间范围为 38.2 天(结肠癌)至 42.7 天(乳腺癌)。

结论

PCI 后,癌症患者发生 AMI 或出血再入院的风险增加,风险幅度取决于癌症类型和转移情况。

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