TY - JOUR
T1 - Percutaneous Coronary Intervention Outcomes in Patients With Prior Thoracic Radiation Therapy
T2 - A Systematic Review and Meta-Analysis
AU - Thakker, Ravi
AU - Suthar, Krishna
AU - Bhakta, Pooja
AU - Lee, Marissa
AU - Jazar, Deaa Abu
AU - Patel, Milee
AU - Elbadawi, Ayman
AU - Albaeni, Aiham
AU - Hasan, Syed Mustajab
AU - Faluk, Mohammed
AU - Willis, Maurice
AU - Chatila, Khaled
AU - Khalife, Wissam
AU - Rangasetty, Umamahesh
AU - Motiwala, Afaq
AU - Gilani, Syed
AU - Jneid, Hani
N1 - Publisher Copyright:
© The authors
PY - 2022
Y1 - 2022
N2 - Background: Thoracic radiation predisposes patients to accelerated coronary artery disease. There is a paucity of data in both short-term and long-term outcomes following revascularization in patients who have undergone thoracic radiation. Methods: We performed a search of the Medline, Cochrane, and Scopus databases for studies that compared outcomes in cancer patients who have undergone thoracic radiation and percutaneous coronary intervention (PCI). The primary outcome of our meta-analysis was all-cause mortality. Secondary outcomes included cardiac mortality, myocardial infarction (MI), and restenosis. Results: The analysis included four observational studies with a total of 13,941 patients for the primary outcome of all-cause mortality. There were a total of 1,322 patients analyzed for cardiac mortality, 13,103 for MI, and 10,530 for restenosis. The longest follow-up for the primary outcome was 16 years. There was statistically significant higher risk of all-cause mortality in patients who underwent thoracic radiation (risk ratio (RR): 1.29, 95% confidence interval (CI): 1.08 - 1.54, P = 0.004). There was no statistically significant difference in cardiac mortality (RR: 1.15, 95% CI: 0.83 - 1.61, P = 0.40), MI (RR: 1.01, 95% CI: 0.20 - 5.08, P = 0.99), and restenosis (RR: 1.92, 95% CI: 0.24 - 15.35, P = 0.54). Conclusion: In this meta-analysis, we found a higher risk of all-cause mortality in patients with a history of thoracic radiation undergoing PCI, likely from underlying malignancy itself.
AB - Background: Thoracic radiation predisposes patients to accelerated coronary artery disease. There is a paucity of data in both short-term and long-term outcomes following revascularization in patients who have undergone thoracic radiation. Methods: We performed a search of the Medline, Cochrane, and Scopus databases for studies that compared outcomes in cancer patients who have undergone thoracic radiation and percutaneous coronary intervention (PCI). The primary outcome of our meta-analysis was all-cause mortality. Secondary outcomes included cardiac mortality, myocardial infarction (MI), and restenosis. Results: The analysis included four observational studies with a total of 13,941 patients for the primary outcome of all-cause mortality. There were a total of 1,322 patients analyzed for cardiac mortality, 13,103 for MI, and 10,530 for restenosis. The longest follow-up for the primary outcome was 16 years. There was statistically significant higher risk of all-cause mortality in patients who underwent thoracic radiation (risk ratio (RR): 1.29, 95% confidence interval (CI): 1.08 - 1.54, P = 0.004). There was no statistically significant difference in cardiac mortality (RR: 1.15, 95% CI: 0.83 - 1.61, P = 0.40), MI (RR: 1.01, 95% CI: 0.20 - 5.08, P = 0.99), and restenosis (RR: 1.92, 95% CI: 0.24 - 15.35, P = 0.54). Conclusion: In this meta-analysis, we found a higher risk of all-cause mortality in patients with a history of thoracic radiation undergoing PCI, likely from underlying malignancy itself.
KW - Cardiotoxicity
KW - Coronary artery disease
KW - Coronary restenosis
KW - Radiation
UR - http://www.scopus.com/inward/record.url?scp=85147029566&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147029566&partnerID=8YFLogxK
U2 - 10.14740/CR1426
DO - 10.14740/CR1426
M3 - Article
AN - SCOPUS:85147029566
SN - 1923-2829
VL - 13
SP - 333
EP - 338
JO - Cardiology Research
JF - Cardiology Research
IS - 6
ER -