Background: Patients with localized and advanced malignancy are usually excluded from randomized clinical trials of drug-eluting stents and anti-platelet therapy. We aimed to evaluate short term outcomes of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with localized and metastatic malignancy. Methods: Analysis from the Nationwide inpatient sample January 2016 to December 2018 of patients with localized and advanced malignancy admitted for a percutaneous coronary intervention with drug-eluting stents. 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: During 2016 – 2018 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. During hospitalization patient with cancer were more likely to develop respiratory failure, need for mechanical ventilation, AKI, and to receive blood products. After multivariate regression analysis patients with localized malignancy did not have any difference in-hospital mortality, total charges, cost, cardiac arrest or post procedural bleeding but had less LOS, respiratory failure, AKI requiring HD, post-procedural CVA and higher post-procedural blood transfusion when compared with patients without cancer. Conclusions: Patients with metastatic malignancy have higher in-hospital mortality when compared to patients without cancer. Patients with localized or advanced malignancy do not have higher in hospital complications. Blood transfusion is higher in patients with malignancy but is not related to procedure.
Reference: No malignancy
Localized malignancy
Metastatic malignancy
aOR
95% CI
p Value
aOR
95% CI
p Value
In-Hospital mortality
0.94
0.80 – 1.12
0.53
1.94
1.52 – 2.49
<0.01
LOS (Days)
Less 0.28
-0.45 to – 0.12
<0.01
Extra 0.91
0.47 – 1.34
<0.01
Total Charges ($)
-3,347
-7,599 – 903
0.12
15,790
6,986 – 24,596
<0.01
Total Cost ($)
-494
-1,290 – 302
0.22
3,765
2,076 – 5,454
<0.01