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The absorbed dose is not related to neoplasm diagnosis in patients with stable angina diagnosed with coronary angiography - insights from the PRESAGE registry
1Silesian Center for Heart Diseases (SCHD), 3rd Department of Cardiology, SMDZ, Medical University of Silesia - Zabrze - Poland
2Silesian Center for Heart Diseases (SCHD), Department of Science, Training and New Technologies - Zabrze - Poland
Background: Ionizing radiation has been recognized as the risk factor of cancer. It is interesting whether the exposure on the X-rays during routine coronary angiography and percutaneous coronary intervention is connected with higher risk of neoplasm.
Purpose: To determine whether the absorbed dose during the coronary angiography and percutaneous coronary intervention was related with the diagnosis of neoplasm in three years after the procedure.
Methods: Consecutive records of 4,435 patients with stable coronary artery disease from the PRESAGE registry, with available 36-month follow-up and data on absorbed dose were included. After excluding 195 patients with the neoplasm diagnosis before the index hospitalization, remaining 4240 patients were analysed. All patients had performed coronary angiography. Neoplasm diagnosis was obtained from National Health Fund records and defined according to the ICD-10 classification as C00-D48 code in 36 months after the coronary angiography. Patients were divided into 2 groups: NPL+ (n=194) - with and NPL- (n=4,046) - without the diagnosis of neoplasm. The groups were compared with Chi2 Pearson and U Mann-Whitney tests and expressed respectively as percentage and median with quartiles 1 and 3 (Q1-Q3). The risk factors of the neoplasm diagnosis were determined with logistic regression and expressed as odds ratio (OR) with 95% confidence interval (CI). P value<0.05 was considered significant.
Results: Patients in NPL+ group were older [66.5 (59.7–72.0) vs. 64.6 (57.7–71.7) years; p=0.030], more frequently with the history of hypertension (88.1 vs. 80.1%; p=0.013) and stroke (9.6 vs. 5.9%; p=0.040), with lower hemoglobin [8.6 (7.7–9.2) vs. 8.7 (8.1–9.2)mmol/l; p=0,041] and kalium [4.3 (4.1–4.6) vs. 4.4 (4.1–4.7)mmol/l; p=0,047] levels on admissions as well as higher platelets count [219 (179–255) vs. 204 (172–244)th/ul; p=0,012] and blood glucose [5.9 (5.2–6.9) vs. 5.6 (5.0–6.7)mmol/l; p=0,049]. During the percutaneous coronary intervention, bare metal stents were preferred in the NPL+ group (23.2 vs. 15.3%; p=0.003). There was no difference in absorbed dose between analysed groups [0.7 (0.4–1.3) vs. 0.6 (0.3–1.0) Gy; p=0.08]. In the multivariate model, male gender (versus female, OR: 1.62; 95% CI: 1.13–2.32; p=0.009), haemoglobin (per 1 mmol/l more, OR: 0.73; 95% CI: 0.62–0.86; p<0.001) and kalium (per 1 mmol/l more, OR: 0.70; 95% CI: 0.51–0.97; p=0.030) levels were risk factors of neoplasm diagnosis. No impact of absorbed dose on the neoplasm diagnosis was noticed (per 1 Gy more, OR: 1.08; 95% CI: 0.88–1.33; p=0.46).
Conclusion: In the group of patients with stable angina diagnosed with coronary angiography, the association of absorbed dose and risk of the neoplasm diagnosis in 3 years was not observed.
ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.
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