TY - JOUR
T1 - Pulmonary embolism, myocardial infarction, and ischemic stroke in lung cancer patients
T2 - Results from a longitudinal study
AU - Van Herk-Sukel, Myrthe P.P.
AU - Shantakumar, Sumitra
AU - Penning-Van Beest, Fernie J.A.
AU - Kamphuisen, Pieter W.
AU - Majoor, Christof J.
AU - Overbeek, Lucy I.H.
AU - Herings, Ron M.C.
PY - 2013/10
Y1 - 2013/10
N2 - Purpose: In this cohort study, the rates of pulmonary embolism (PE), myocardial infarction (MI), and ischemic stroke (IS) before and after lung cancer (LC) diagnosis were compared to cancer-free controls. Methods: Patients with LC during 2000-2007 were selected from PALGA, the Dutch Pathology Registry, and linked to the PHARMO medical record linkage system, including drug use and hospitalizations of 3 million inhabitants in the Netherlands. Included LC patients were matched 1:10 by age and gender to cancer-free controls. Hospitalizations for PE, MI, and IS were assessed in the 12 months before and after LC diagnosis. Results: LC patients (N = 3,717) were six times more likely than cancer-free controls to have had a PE in the 12 months before diagnosis. After LC diagnosis, patients experienced an extremely increased risk of PE in the first 6 months (hazard ratio [HR] 16.8; 95 % confidence interval [CI] 7.6-36.8) compared with controls), which decreased to a five times increased risk (HR 5.1; 95 % CI 2.7-9.4) thereafter. However, there were less than two events per 100 person years during both time periods. LC patients receiving chemotherapy were eight times more likely to develop PE, whereas surgery increased the risk on PE three times. For MI and IS, no significant difference was observed compared with cancer-free controls before or after LC diagnosis. Conclusions: LC patients have a higher risk of developing PE compared with cancer-free controls, although the frequency of PE hospitalizations was low. Surgery and chemotherapy were associated with an increased risk of PE.
AB - Purpose: In this cohort study, the rates of pulmonary embolism (PE), myocardial infarction (MI), and ischemic stroke (IS) before and after lung cancer (LC) diagnosis were compared to cancer-free controls. Methods: Patients with LC during 2000-2007 were selected from PALGA, the Dutch Pathology Registry, and linked to the PHARMO medical record linkage system, including drug use and hospitalizations of 3 million inhabitants in the Netherlands. Included LC patients were matched 1:10 by age and gender to cancer-free controls. Hospitalizations for PE, MI, and IS were assessed in the 12 months before and after LC diagnosis. Results: LC patients (N = 3,717) were six times more likely than cancer-free controls to have had a PE in the 12 months before diagnosis. After LC diagnosis, patients experienced an extremely increased risk of PE in the first 6 months (hazard ratio [HR] 16.8; 95 % confidence interval [CI] 7.6-36.8) compared with controls), which decreased to a five times increased risk (HR 5.1; 95 % CI 2.7-9.4) thereafter. However, there were less than two events per 100 person years during both time periods. LC patients receiving chemotherapy were eight times more likely to develop PE, whereas surgery increased the risk on PE three times. For MI and IS, no significant difference was observed compared with cancer-free controls before or after LC diagnosis. Conclusions: LC patients have a higher risk of developing PE compared with cancer-free controls, although the frequency of PE hospitalizations was low. Surgery and chemotherapy were associated with an increased risk of PE.
KW - Ischemic stroke
KW - Myocardial infarction
KW - Non-small cell lung cancer
KW - Pulmonary embolism
KW - Risk
KW - Small cell lung cancer
UR - http://www.scopus.com/inward/record.url?scp=84884812327&partnerID=8YFLogxK
U2 - 10.1007/s00408-013-9485-1
DO - 10.1007/s00408-013-9485-1
M3 - Article
C2 - 23807721
AN - SCOPUS:84884812327
SN - 0341-2040
VL - 191
SP - 501
EP - 509
JO - Lung
JF - Lung
IS - 5
ER -