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. 2025 Sep 22:61:101806.
doi: 10.1016/j.ijcha.2025.101806. eCollection 2025 Dec.

Short and long-term outcomes of percutaneous coronary intervention in patients with active or prior history of cancer: a systematic review and meta-analysis

Nikolaos Vythoulkas-Biotis  1 , David-Dimitris Chlorogiannis  2 , Theoni Theodoropoulou  3 , Ioannis Gialamas  1 , Evangelos Oikonomou  1 , Konstantinos Kalogeras  1 , Helena Michalopoulou  1 , Gerasimos Siasos  1 , Manolis Vavuranakis  1
Affiliations

Short and long-term outcomes of percutaneous coronary intervention in patients with active or prior history of cancer: a systematic review and meta-analysis

Nikolaos Vythoulkas-Biotis et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Percutaneous coronary intervention (PCI) in patients with active or prior history of cancer presents a challenge due to the increased rates of cardiovascular complications. Therefore, we aimed to evaluate the mortality rates, in addition to early and long-term adverse cardiovascular outcomes in this high-risk population.

Methods: A systematic literature search was conducted across PubMed, Cochrane, and Scopus databases to identify eligible studies comparing clinical outcomes between patients with active or prior history of cancer and patients without cancer. Our primary outcomes were all-cause mortality and cardiovascular mortality at different time points. Secondary outcomes included bleeding, stroke, recurrent myocardial infarction (MI), and heart failure events between the two groups.

Results: Overall, 18 studies with a total of 8 million patients were included. Active or prior history of cancer was associated with increased in-hospital all-cause mortality (RR: 1.43; 95 % CI: 1.03-1.99; p = 0.03), 1-year all-cause mortality (RR: 2.35; 95 % CI: 1.75-3.16; p < 0.001), as well as, increased 1-year cardiovascular mortality (RR: 1.35; 95 % CI: 1.15-1.59; p < 0.001) compared to patients without a history of cancer. Patients with active or prior history of cancer have higher rates of in-hospital (RR: 1.77; 95 % CI: 1.75-1.79; p < 0.001), 1-year (RR: 1.63; 95 %CI: 1.26-2.11; p < 0.001), and long-term bleeding events (RR: 2.08; 95 % CI: 1.30-3.35; p < 0.003) compared to patients without cancer. No significant differences were recorded regarding recurrent MI between the two groups.

Conclusions: Active or prior history of cancer was associated with a negative impact on early and long-term clinical outcomes in patients undergoing PCI. These findings underline the importance of individualized and multidisciplinary approaches when treating this high-risk population.

Keywords: Cancer; Coronary artery disease; Meta-analysis; Outcomes; Percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
PRISMA flowchart for study selection.
Fig. 2
Fig. 2
Forest plots of all-cause mortality outcomes in patients with active or prior history of cancer following PCI. (A) In-hospital all-cause mortality. (B) 1-year all-cause mortality. (C) Long-term all-cause mortality. Relative risks were calculated using random effects model, and are presented as squares, while 95% confidence intervals are being displayed as horizontal lines.
Fig. 3
Fig. 3
Forest plots of cardiovascular mortality outcomes in patients with active or prior history of cancer following PCI. (A) In-hospital cardiovascular mortality. (B) 1-year cardiovascular mortality. (C) Long-term cardiovascular mortality. Relative risks were calculated using random effects model, and are presented as squares, while 95% confidence intervals are being displayed as horizontal lines.
Fig. 4
Fig. 4
Forest plots of in-hospital adverse cardiovascular events in patients with active or prior history of cancer following PCI. (A) Bleeding. (B) Stroke. (C) Recurrent myocardial infarction. (D) Heart failure. (E) Cardiogenic shock. Relative risks were calculated using random effects model, and are presented as squares, while 95% confidence intervals are being displayed as horizontal lines.
Fig. 5
Fig. 5
Forest plots of 1-year adverse cardiovascular outcomes in patients with active or prior history of cancer after PCI. (A) Bleeding. (B) Stroke. (C) Recurrent myocardial infarction. Relative risks were calculated using random effects model, and are presented as squares, while 95% confidence intervals are being displayed as horizontal lines.
Fig. 6
Fig. 6
Forest plots of long-term adverse cardiovascular outcomes in patients with active or prior history of cancer after PCI. (A) Bleeding. (B) Stroke. (C) Recurrent myocardial infarction. (D) Heart failure. Relative risks were calculated using random effects model, and are presented as squares, while 95% confidence intervals are being displayed as horizontal lines.
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