Abstract 16748: Stent Type and Outcomes in Patients With Malignancy Undergoing Percutaneous Coronary Intervention

Abstract

Background: Coronary artery disease and cancer share some of the same risk factors, so it is not uncommon to find them in same patient. So PCI is increasingly performed in these patients. However type of stent and its impact on mortality is largely unknown. Methods: Nationwide Inpatient Sample (HCUP-NIS) database was utilized to identify patient who have underwent BMS or DES placement and had active cancer. Appropriate ICD 9 codes was used to identify lung, colon, breast, prostrate, hematological, liver, brain and kidney cancer as well as metastatic cancer. Patient were randomly assigned in 1:1 ratio to BMS and DES group. Propensity score analysis was performed using neighborhood matching to baseline co-variates and reduce confounding bias. Percentage of patients getting BMS and DES were analyzed and compared to general population. While comparing DES and BMS group, outcomes included in-hospital mortality, stent thrombosis, length of stay, acute kidney injury and bleeding complications.R esults: A total of 8755 patients were selected in BMS group and 11,611 patients were selected in DES group. Following propensity matching, 4313 patients were selected in both groups and randomly assigned 1:1 ratio to BMS and DES. As compared to general population (BMS 23.2%, DES 76.8%), there is high use of BMS stent in cancer patient (BMS 43.0%, DES 57.2%). When comparing BMS to DES group, there is no statistically significant difference in mortality (4.7 vs 3.8 percent p=0.097), acute kidney injury (11.3 in BMS vs 10.6 in DES p = 0.425), bleeding complications (3.50 in BMS vs 3.45 in DES p = 0.914) and length of stay (5.4 in BMS vs 5.2 in DES p = 0.119). There is increased incidence of stent thrombosis in DES group (4.26% vs 3.01%, p-value 0.02). Among the cancers, adjusted for type of stent placed, liver and pancreatic cancer was associated with significant increase in stent thrombosis Conclusion: In patients with active malignancy, there is higher incidence of BMS placement as compared to general population. There is high incidence of stent thrombosis is DES without increase in mortality. Among the cancers, adjusted for type of stent placed, liver and pancreatic cancer was associated with significant increase in stent thrombosis