Post-PCI Deaths Increasingly From Noncardiac Causes
(HealthDay News) —Deaths following percutaneous coronary intervention (PCI) have shifted from cardiac to noncardiac causes over the past two decades, according to a study published online February 10 in Circulation.
Daniel B. Spoon, MD, from the Mayo Clinic in Rochester, MN, and colleagues examined cause-specific long-term mortality trends following index PCI performed at a single center from 1991–2008. Cause-specific mortality was analyzed for three time periods of PCI (1991–1996; 1997–2002; and 2003– 2008), with final follow-up December 31, 2012.
The researchers found that, across the three time periods, the incidence of cardiac deaths at five-years after PCI decreased by 33% (incidence: 9.8, 7.4, and 6.6%, respectively), while noncardiac death increased by 57% (7.1, 8.5, and 11.2%, respectively). In the most recent time period, 36.8% of deaths were cardiac. Trends were similar irrespective of age, extent of coronary disease, or PCI indication. After baseline variable adjustment, cardiac mortality decreased by 50%, but noncardiac mortality did not change. The decrease in cardiac mortality was attributed to a reduction in deaths from myocardial infarction/sudden death (P<0.001), but not heart failure (P=0.85). Cancer and chronic diseases were the main contributors to the increase (P<0.001) in noncardiac mortality.
"This study found a marked temporal switch from predominantly cardiac to predominantly noncardiac cardiac causes of death after PCI over two decades," the authors write.