Percutaneous Coronary Intervention Outcomes in Patients With Prior Thoracic Radiation Therapy: A Systematic Review and Meta-Analysis

Ravi Thakker, Krishna Suthar, Pooja Bhakta, Marissa Lee, Deaa Abu Jazar, Milee Patel, Ayman Elbadawi, Aiham Albaeni, Syed Mustajab Hasan, Mohammed Faluk, Maurice Willis, Khaled Chatila, Wissam Khalife, Umamahesh Rangasetty, Afaq Motiwala, Syed Gilani, Hani Jneid

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)333-338
Number of pages6
JournalCardiology Research
Volume13
Issue number6
DOIs
StatePublished - 2022

Keywords

  • Cardiotoxicity
  • Coronary artery disease
  • Coronary restenosis
  • Radiation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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