Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, Barac, A, Contractor, T, Silvet, H, Arroyo, RC, Parwani, P, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Martin, G, Patwala, A and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2020) Prevalence and in-hospital outcomes of patients with malignancies undergoing de novo cardiac electronic device implantation in the United States. EP-Europace.

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CIED cancer paper Final Europace.docx - Accepted Version
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Abstract

Aims: To study the outcomes of cancer patients undergoing cardiac implantable electronic device (CIED) implantation.

Methods: De novo CIED implantations (2004 to 2015; n=2,670,590) from the National Inpatient Sample were analysed for characteristics and in-hospital outcomes, stratified by presence of cancer (no cancer, historical and current cancers) and further by current cancer type (haematological, lung, breast, colon and prostate).

Results: Current and historical cancer prevalence has increased from 3.3% to 7.8%, and 5.8% to 7.8%, respectively between 2004 to 2015. Current cancer was associated with increased adjusted odd ratios (OR) of MACE (composite of all-cause mortality, thoracic and cardiac complications, and device-related infection; OR 1.26, 95% confidence interval (CI) 1.23,1.30), all-cause mortality (OR 1.43, 95%CI 1.35,1.50), major bleeding (OR 1.38, 95%CI 1.32,1.44) and thoracic complications (OR 1.39, 95%CI 1.35,1.43). Differences in outcomes were observed according to cancer type, with significantly worse MACE, mortality and thoracic complications with lung and haematological malignancies, and increased major bleeding in colon and prostate malignancies. The risk of complications was also different according to CIED subtype.

Conclusion: The prevalence of cancer patients amongst those undergoing CIED implantation has significantly increased over 12 years. Overall, current cancers are associated with increased mortality and worse outcomes, especially in patients with lung, haematological and colon malignancies whereas there was no evidence that historical cancer had a negative impact on outcomes.

Item Type: Article
Additional Information: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Uncontrolled Keywords: Cardiac devices, pacemakers, defibrillator, cardiac resynchronization, cancer, malignancy, outcomes
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 27 Mar 2020 09:49
Last Modified: 13 May 2020 14:40
URI: https://eprints.keele.ac.uk/id/eprint/7847

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