Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4305 |
Resumo: | Introduction: The management of acute coronary syndrome (ACS) in malignancy is challenging due to higher bleeding risk. Methods: We analyzed patients with cancer (active or in the previous five years) prospectively included in the ProACS registry between 2010 and 2019. Our aim was to assess safety (major bleeding, primary endpoint) and secondary efficacy endpoints (in-hospital mortality and combined in-hospital mortality, reinfarction and ischemic stroke) of ACS treatment. Propensity score matching analysis (1:1) was further performed to better understand predictors of outcomes. Results: We found 934 (5%) cancer patients out of a total of 18 845 patients with ACS. Cancer patients had more events: major bleeding (2.9% vs. 1.5%), in-hospital mortality (5.8% vs. 3.4%) and the combined endpoint (7.4% vs. 4.9%). The primary endpoint was related to cancer diagnosis (OR 1.97), previous bleeding (OR 7.09), hemoglobin level (OR 4.94), atrial fibrillation (OR 3.50), oral anticoagulation (OR 3.67) and renal dysfunction. Mortality and the combined secondary endpoint were associated with lower use of invasive coronary angiography and antiplatelet and neurohormonal blocker therapy. After propensity score matching (350 patients), there were no statistically significant differences in endpoints between the populations. Conclusion: Bleeding risk was not significant higher in the cancer population compared to patients with similar characteristics, nor were mortality or ischemic risk. The presence of cancer should not preclude simultaneous ACS treatment. |
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Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS RegistryDoentes Oncológicos com Síndrome Coronária Aguda Não Têm Maior Risco Hemorrágico Quando Comparados com Doentes com Características Similares - Uma Análise de Emparelhamento de Score de Propensão do Registo ProACSHSM CARAcute Coronary SyndromeBleedingCancerCardio-OncologyIntroduction: The management of acute coronary syndrome (ACS) in malignancy is challenging due to higher bleeding risk. Methods: We analyzed patients with cancer (active or in the previous five years) prospectively included in the ProACS registry between 2010 and 2019. Our aim was to assess safety (major bleeding, primary endpoint) and secondary efficacy endpoints (in-hospital mortality and combined in-hospital mortality, reinfarction and ischemic stroke) of ACS treatment. Propensity score matching analysis (1:1) was further performed to better understand predictors of outcomes. Results: We found 934 (5%) cancer patients out of a total of 18 845 patients with ACS. Cancer patients had more events: major bleeding (2.9% vs. 1.5%), in-hospital mortality (5.8% vs. 3.4%) and the combined endpoint (7.4% vs. 4.9%). The primary endpoint was related to cancer diagnosis (OR 1.97), previous bleeding (OR 7.09), hemoglobin level (OR 4.94), atrial fibrillation (OR 3.50), oral anticoagulation (OR 3.67) and renal dysfunction. Mortality and the combined secondary endpoint were associated with lower use of invasive coronary angiography and antiplatelet and neurohormonal blocker therapy. After propensity score matching (350 patients), there were no statistically significant differences in endpoints between the populations. Conclusion: Bleeding risk was not significant higher in the cancer population compared to patients with similar characteristics, nor were mortality or ischemic risk. The presence of cancer should not preclude simultaneous ACS treatment.Elsevier EspañaRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEMano, TTimóteo, ATAguiar Rosa, SBelo, ACruz Ferreira, RProACS Registry Investigators2022-12-06T16:08:12Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4305engRev Port Cardiol . 2022 Jul;41(7):573-582.10.1016/j.repc.2021.04.010.info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:46:10Zoai:repositorio.chlc.min-saude.pt:10400.17/4305Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:21:37.903962Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry Doentes Oncológicos com Síndrome Coronária Aguda Não Têm Maior Risco Hemorrágico Quando Comparados com Doentes com Características Similares - Uma Análise de Emparelhamento de Score de Propensão do Registo ProACS |
title |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
spellingShingle |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry Mano, T HSM CAR Acute Coronary Syndrome Bleeding Cancer Cardio-Oncology |
title_short |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
title_full |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
title_fullStr |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
title_full_unstemmed |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
title_sort |
Cancer Patients with Acute Coronary Syndrome Have Non-Superior Bleeding Risk Compared to Patients with Similar Characteristics - a Propensity Score Analysis from the ProACS Registry |
author |
Mano, T |
author_facet |
Mano, T Timóteo, AT Aguiar Rosa, S Belo, A Cruz Ferreira, R ProACS Registry Investigators |
author_role |
author |
author2 |
Timóteo, AT Aguiar Rosa, S Belo, A Cruz Ferreira, R ProACS Registry Investigators |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Mano, T Timóteo, AT Aguiar Rosa, S Belo, A Cruz Ferreira, R ProACS Registry Investigators |
dc.subject.por.fl_str_mv |
HSM CAR Acute Coronary Syndrome Bleeding Cancer Cardio-Oncology |
topic |
HSM CAR Acute Coronary Syndrome Bleeding Cancer Cardio-Oncology |
description |
Introduction: The management of acute coronary syndrome (ACS) in malignancy is challenging due to higher bleeding risk. Methods: We analyzed patients with cancer (active or in the previous five years) prospectively included in the ProACS registry between 2010 and 2019. Our aim was to assess safety (major bleeding, primary endpoint) and secondary efficacy endpoints (in-hospital mortality and combined in-hospital mortality, reinfarction and ischemic stroke) of ACS treatment. Propensity score matching analysis (1:1) was further performed to better understand predictors of outcomes. Results: We found 934 (5%) cancer patients out of a total of 18 845 patients with ACS. Cancer patients had more events: major bleeding (2.9% vs. 1.5%), in-hospital mortality (5.8% vs. 3.4%) and the combined endpoint (7.4% vs. 4.9%). The primary endpoint was related to cancer diagnosis (OR 1.97), previous bleeding (OR 7.09), hemoglobin level (OR 4.94), atrial fibrillation (OR 3.50), oral anticoagulation (OR 3.67) and renal dysfunction. Mortality and the combined secondary endpoint were associated with lower use of invasive coronary angiography and antiplatelet and neurohormonal blocker therapy. After propensity score matching (350 patients), there were no statistically significant differences in endpoints between the populations. Conclusion: Bleeding risk was not significant higher in the cancer population compared to patients with similar characteristics, nor were mortality or ischemic risk. The presence of cancer should not preclude simultaneous ACS treatment. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-06T16:08:12Z 2022 2022-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4305 |
url |
http://hdl.handle.net/10400.17/4305 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Port Cardiol . 2022 Jul;41(7):573-582. 10.1016/j.repc.2021.04.010. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier España |
publisher.none.fl_str_mv |
Elsevier España |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131311001042944 |