Multivessel Coronary Artery Disease in Cancer Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

TL;DR

This study found no significant difference in the occurrence of multivessel coronary artery disease between cancer patients and non-cancer patients undergoing PCI.

Contribution

The study provides a meta-analysis comparing MVD in cancer and non-cancer patients undergoing PCI, addressing a gap in cardiovascular-cancer research.

Findings

Overall, cancer patients did not show a significantly higher risk of MVD compared to non-cancer patients (RR: 1.03, p = 0.19).

Sub-analysis with matched control populations also found no significant difference in MVD (RR: 0.99, p = 0.79).

High heterogeneity (I2 = 57.32%) was observed among the included studies.

Abstract

Cancer patients have a higher propensity for adverse cardiovascular outcomes, primarily due to the toxic effects of chemotherapeutic agents and radiation therapy. The objective of this systematic review and meta-analysis was to investigate the proportion of multivessel coronary artery disease (MVD) in cancer compared to non-cancer patients undergoing percutaneous coronary intervention (PCI). We systematically screened the literature for studies providing data on MVD in patients with and without cancer who underwent PCI. Seventeen observational studies (5200 patients with active cancer/history of cancer and 55,146 control patients without cancer) were included in the analysis. Most studies did not show statistically significant differences in the incidence of MVD. Overall, there was no significant difference in MVD occurrence in the cancer group (risk ratio [RR]: 1.03; 95% confidence intervals [CI]: 0.99–1.08; p = 0.19). A high degree of heterogeneity was observed among the studies (I2 = 57.32%). Further sub-analysis using only the six studies with matched control populations did not show significant differences in MVD between those groups (RR; 0.99, 95% CI: 0.94–1.05, p = 0.79). In addition, a subgroup analysis with patients who had acute coronary syndrome, who received radiation treatment, and in studies with cancer patients with active cancer did not change the statistical results. Our report highlights that there was no significant difference in the incidence of MVD between patients with and without cancer. Further research is needed to clarify the detailed characteristics of coronary artery disease in cancer patients.

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