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Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention

癌症对急性冠状动脉综合征和/或经皮冠状动脉介入治疗患者预后影响的系统评价和荟萃分析

  • 影响因子:2.06
  • DOI:10.1186/s12872-020-01352-0
  • 作者列表:"Vincent Roule","Laurine Verdier","Katrien Blanchart","Pierre Ardouin","Adrien Lemaitre","Mathieu Bignon","Rémi Sabatier","Joachim Alexandre","Farzin Beygui
  • 发表时间:2020-02-02
Abstract

Abstract Background Patients with cancer admitted for an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) represent a growing and high-risk population. The influence of co-existing cancer on mortality remains unclear in such patients. We aimed to assess the impact of cancer on early and late, all-cause and cardiac mortality in the setting of ACS and/or PCI. Methods We performed a systematic review and meta-analysis of studies comparing outcomes of patients with and without a history of cancer admitted for ACS and/or PCI. Results Six studies including 294,528 ACS patients and three studies including 39,973 PCI patients were selected for our meta-analysis. Patients with cancer had increased rates of in-hospital all-cause death (RR 1.74 [1.22; 2.47]), cardiac death (RR 2.44 [1.73; 3.44]) and bleeding (RR 1.64 [1.35; 1.98]) as well as one-year all-cause death (RR 2.62 [1.2; 5.73]) and cardiac death (RR 1.89 [1.25; 2.86]) in ACS studies. Rates of long term all-cause (RR 1.96 [1.52; 2.53]) but not cardiac death were higher in cancer patients admitted for PCI. Conclusion Cancer patients represent a high-risk population both in the acute phase and at long-term after an ACS or PCI. The magnitude of the risk of mortality should however be tempered by the heterogeneity among studies. Early and long term optimal management of such patients should be promoted in clinical practice.

摘要

【摘要】背景: 因急性冠状动脉综合征 (ACS) 和/或经皮冠状动脉介入治疗 (PCI) 而入院的癌症患者代表了越来越多的高危人群。并存癌症对此类患者死亡率的影响仍不清楚。我们旨在评估癌症对 ACS 和/或 PCI 背景下早期和晚期、全因和心脏死亡率的影响。方法我们对比较有和无癌症病史的 ACS 和/或 PCI 患者的结局的研究进行了系统综述和荟萃分析。结果共纳入 6 项研究 (包括 294,528 例 ACS 患者) 和 3 项研究 (包括 39,973 例 PCI 患者) 进行 meta 分析。癌症患者院内全因死亡率 (RR 1.74 [1.22; 2.47]) 、心源性死亡 (RR 2.44 [1.73; 3.44]) 增加和出血 (RR 1.64 [1.35; 1.98]) 以及一年全因死亡 (RR 2.62 [1.2; 5.73]) 和心源性死亡 (RR 1.89[1.25; 2.86]) 在 ACS 研究中。接受 PCI 的癌症患者的长期全因 (RR 1.96 [1.52; 2.53]) 发生率较高,而非心源性死亡。结论癌症患者是 ACS 或 PCI 术后急性期和长期的高危人群。然而,研究之间的异质性应缓和死亡风险的大小。应在临床实践中推广此类患者的早期和长期优化管理。

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作者列表:["Jain M","Dhanesha N","Doddapattar P","Chorawala MR","Nayak MK","Cornelissen A","Guo L","Finn AV","Lentz SR","Chauhan AK"]

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影响因子:4.65
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DOI:10.1161/ATVBAHA.119.313602
作者列表:["Lee SY","Ahn JM","Mintz GS","Hong SJ","Ahn CM","Park DW","Kim JS","Kim BK","Ko YG","Choi D","Jang Y","Park SJ","Hong MK"]

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