In-Hospital Characteristics and 30-Day Readmissions for Acute Myocardial Infarction and Major Bleeding in Patients With Active Cancer

被引:2
作者
Lahan, Shubham [1 ]
Bharadwaj, Aditya [2 ]
Cheng, Richard [3 ]
Parwani, Purvi [2 ]
Miller, Robert [4 ]
Cheung, Winson [5 ]
Bianco, Christopher [6 ]
Kheiri, Babikir [7 ]
Osman, Mohammed [7 ]
Mohamed, Mohamed [8 ,9 ]
Mamas, Mamas [8 ,9 ]
机构
[1] Houston Methodist Hosp, Dept Cardiol, Houston, TX 77030 USA
[2] Loma Linda Univ Hlth, Dept Med, Div Cardiol, Loma Linda, CA USA
[3] Univ Washington, Div Cardiol, Seattle, WA 98195 USA
[4] Univ Calgary, Dept Cardiac Sci, Calgary, AB, Canada
[5] Univ Calgary, Tom Baker Canc Ctr, Calgary, AB, Canada
[6] West Virginia Univ, Sch Med, Dept Cardiol, Morgantown, WV 26506 USA
[7] Oregon Hlth & Sci Univ, Knight Cardiovasc Inst, Portland, OR 97201 USA
[8] Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England
[9] Royal Stoke Univ Hosp, Dept Cardiol, Stoke On Trent, Staffs, England
关键词
OUTCOMES; THERAPY; IMPACT;
D O I
10.1016/j.amjcard.2021.11.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
There are limited data on readmission with ischemic and major bleeding events in patients with acute myocardial infarction (AMI) with active cancer. The purpose of our study was to evaluate in-hospital characteristics and 30-day readmission rates for recurrent AMI and major bleeding by cancer type in patients with AMI and active cancer. From 2016 through 2018, patients in the Nationwide Readmission Database admitted with AMI and underlying active colon, lung, breast, prostate, and hematological cancers were included. Thirty-day readmission for recurrent AMI and major bleeding were reported. Of 1,524,677 index hospitalizations for AMI, 35,790 patients (2.2%) had cancer (0.9% hematological; 0.5% lung; 0.4% prostate; 0.2% breast; and 0.1% colon). Compared with patients without cancer, patients with cancer were about 6 to 10 years older and had a higher proportion of atrial fibrillation, valvular heart disease, previous stroke, and a greater co-morbidity burden. Of all cancer types, only active breast cancer (adjusted odds ratios 1.82, 95% CI 1.11 to 2.98) was found to be significantly associated with elevated odds of readmission for major bleeding; no such association was observed for recurrent AMI. In conclusion, AMI in patients with breast cancer is associated with significantly greater odds of readmission for major bleeding within 30 days after discharge. Management of patients with concomitant AMI and cancer is challenging but should be based on a multidisciplinary approach and estimation of an individual patient's risk of major coronary thrombotic and bleeding events. (C) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:25 / 37
页数:13
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