Michael Schechter1, Dinu Valentin Balanescu2, Teodora Donisan2, Tariq J Dayah1, Biswajit Kar1, Igor Gregoric1, Dana E Giza3, Juhee Song4, Juan Lopez-Mattei2, Peter Kim2, Serban Mihai Balanescu5, Mehmet Cilingiroglu6,7, Konstantinos Toutouzas8, Richard W Smalling1, Konstantinos Marmagkiolis7, Cezar Iliescu2. 1. Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas. 2. Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Family and Community Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Cardiology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 6. Department of Cardiology, Arkansas Heart Hospital, Little Rock, Arkansas. 7. Florida Hospital Pepin Heart Institute, Tampa, Florida. 8. First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University Medical School, Athens, Greece.
Abstract
OBJECTIVES: We compared the outcomes of aortic valve replacement (AVR) by transcatheter (TAVR) and surgical (SAVR) routes with those of optimal medical management in patients with cancer and severe aortic stenosis (AS). BACKGROUND: Cancer therapy requires optimal cardiac output; however, the treatment of AS in cancer patients is not established. METHODS: Cancer patients with severe AS during January 2009 through February 2018 at a large cancer center were identified. Demographic and clinical characteristics including previous or active cancer diagnosis, history of chest radiotherapy, AS treatment, and survival were collected. Univariate Cox proportional hazards regression, the Kaplan-Meier analysis, and log-rank tests were used to compare overall survival (OS) between AS treatment groups. RESULTS: Sixty-five cancer patients with severe AS were identified; 28 received optimal medical treatment alone, 30 received TAVR, and seven received SAVR. The patients were predominantly male (n = 44, 68%) with a mean age of 71.17 years. The median OS was 9.87 months, and the most common cause of death was cancer (n = 29, 94% of deaths). AVR was associated with a lower risk of death than no AVR (hazard ratio [HR] 0.38, P = 0.007), and patients who underwent TAVR (HR 0.36, P = 0.01) had better survival than those with no AVR. Malignancy type, stage, and treatment were not associated with OS. CONCLUSIONS: Patients with cancer and severe AS who underwent AVR, predominantly TAVR, experienced better survival than those who had no AVR regardless of cancer type or cancer treatment. TAVR may be considered in patients with cancer and AS.
OBJECTIVES: We compared the outcomes of aortic valve replacement (AVR) by transcatheter (TAVR) and surgical (SAVR) routes with those of optimal medical management in patients with cancer and severe aortic stenosis (AS). BACKGROUND:Cancer therapy requires optimal cardiac output; however, the treatment of AS in cancerpatients is not established. METHODS:Cancerpatients with severe AS during January 2009 through February 2018 at a large cancer center were identified. Demographic and clinical characteristics including previous or active cancer diagnosis, history of chest radiotherapy, AS treatment, and survival were collected. Univariate Cox proportional hazards regression, the Kaplan-Meier analysis, and log-rank tests were used to compare overall survival (OS) between AS treatment groups. RESULTS: Sixty-five cancerpatients with severe AS were identified; 28 received optimal medical treatment alone, 30 received TAVR, and seven received SAVR. The patients were predominantly male (n = 44, 68%) with a mean age of 71.17 years. The median OS was 9.87 months, and the most common cause of death was cancer (n = 29, 94% of deaths). AVR was associated with a lower risk of death than no AVR (hazard ratio [HR] 0.38, P = 0.007), and patients who underwent TAVR (HR 0.36, P = 0.01) had better survival than those with no AVR. Malignancy type, stage, and treatment were not associated with OS. CONCLUSIONS:Patients with cancer and severe AS who underwent AVR, predominantly TAVR, experienced better survival than those who had no AVR regardless of cancer type or cancer treatment. TAVR may be considered in patients with cancer and AS.
Authors: Serban Mihai Balanescu; Dinu Valentin Balanescu; Teodora Donisan; Eric H Yang; Nicolas Palaskas; Juan Lopez-Mattei; Saamir Hassan; Peter Kim; Mehmet Cilingiroglu; Konstantinos Marmagkiolis; Biswajit Kar; Cezar Iliescu Journal: Curr Cardiol Rep Date: 2019-07-08 Impact factor: 2.931
Authors: Michael E Layoun; Eric H Yang; Joerg Herrmann; Cezar A Iliescu; Juan C Lopez-Mattei; Kostas Marmagkiolis; Matthew J Budoff; Maros Ferencik Journal: Curr Treat Options Oncol Date: 2019-05-06
Authors: Katia Bravo-Jaimes; Nicolas L Palaskas; Jose Banchs; Nadia I Abelhad; Alveena Altaf; Sushanth Gouni; Juhee Song; Saamir A Hassan; Cezar Iliescu; Anita Deswal; Syed Wamique Yusuf Journal: Front Cardiovasc Med Date: 2021-03-18