Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation

Yoshitaka Kitamura, Kenji Suzuki, Satoshi Teramukai, Makoto Sonobe, Shinichi Toyooka, Yoshihisa Nakagawa, Hiroyasu Yokomise, Hiroshi Date, J. Arikura, M. Miyajima, N. Tsunooka, S. Ueda, S. Shiono, H. Ichimura, Y. Ohtaki, O. Kawashima, N. Takahashi, T. Iwata, T. Murakawa, Y. Shimada & 47 others H. Horio, H. Ishibashi, R. Kawachi, T. Omori, M. Naito, T. Hashimoto, R. Waseda, Y. Tsunezuka, N. Tanaka, T. Eguchi, H. Agatsuma, Y. Mizuno, S. Nishikawa, M. Isaka, H. Haneda, K. Narita, K. Okuda, Y. Kobayashi, Y. Terada, T. Takemoto, R. Nakajima, R. Kanzaki, J. Okami, Y. Kadota, N. Hanaoka, A. Hayashi, W. Nishio, Y. Takahashi, H. Nakamura, Y. Taniguchi, A. Yamashina, H. Yamamoto, Y. Miyata, M. Matsuura, T. Tanaka, N. Matsuura, H. Suehisa, S. S. Chang, T. So, T. Osaki, S. Takeo, M. Takenoyama, T. Miyazaki, T. Marutsuka, K. Yoshimoto, K. Kariatsumari, M. Yanagi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. Methods We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. Results Among the 1,254 patients, 902 (71.9%) and 452 patients (36.0%) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8%) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4%), 204 (16.3%) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6% (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. Conclusions Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.

Original languageEnglish
Pages (from-to)432-440
Number of pages9
JournalAnnals of Thoracic Surgery
Volume103
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

Fingerprint

Atrial Fibrillation
Coronary Artery Disease
Lung Neoplasms
Lung
Hospital Mortality
Stents
Coronary Stenosis
Thrombosis
Hemorrhage
Cerebrovascular Disorders
Drug-Eluting Stents
Blood Transfusion
Heart Diseases
Japan
Therapeutics
Multivariate Analysis
Heart Failure
Odds Ratio
Mortality

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation. / Kitamura, Yoshitaka; Suzuki, Kenji; Teramukai, Satoshi; Sonobe, Makoto; Toyooka, Shinichi; Nakagawa, Yoshihisa; Yokomise, Hiroyasu; Date, Hiroshi; Arikura, J.; Miyajima, M.; Tsunooka, N.; Ueda, S.; Shiono, S.; Ichimura, H.; Ohtaki, Y.; Kawashima, O.; Takahashi, N.; Iwata, T.; Murakawa, T.; Shimada, Y.; Horio, H.; Ishibashi, H.; Kawachi, R.; Omori, T.; Naito, M.; Hashimoto, T.; Waseda, R.; Tsunezuka, Y.; Tanaka, N.; Eguchi, T.; Agatsuma, H.; Mizuno, Y.; Nishikawa, S.; Isaka, M.; Haneda, H.; Narita, K.; Okuda, K.; Kobayashi, Y.; Terada, Y.; Takemoto, T.; Nakajima, R.; Kanzaki, R.; Okami, J.; Kadota, Y.; Hanaoka, N.; Hayashi, A.; Nishio, W.; Takahashi, Y.; Nakamura, H.; Taniguchi, Y.; Yamashina, A.; Yamamoto, H.; Miyata, Y.; Matsuura, M.; Tanaka, T.; Matsuura, N.; Suehisa, H.; Chang, S. S.; So, T.; Osaki, T.; Takeo, S.; Takenoyama, M.; Miyazaki, T.; Marutsuka, T.; Yoshimoto, K.; Kariatsumari, K.; Yanagi, M.

In: Annals of Thoracic Surgery, Vol. 103, No. 2, 01.02.2017, p. 432-440.

Research output: Contribution to journalArticle

Kitamura, Y, Suzuki, K, Teramukai, S, Sonobe, M, Toyooka, S, Nakagawa, Y, Yokomise, H, Date, H, Arikura, J, Miyajima, M, Tsunooka, N, Ueda, S, Shiono, S, Ichimura, H, Ohtaki, Y, Kawashima, O, Takahashi, N, Iwata, T, Murakawa, T, Shimada, Y, Horio, H, Ishibashi, H, Kawachi, R, Omori, T, Naito, M, Hashimoto, T, Waseda, R, Tsunezuka, Y, Tanaka, N, Eguchi, T, Agatsuma, H, Mizuno, Y, Nishikawa, S, Isaka, M, Haneda, H, Narita, K, Okuda, K, Kobayashi, Y, Terada, Y, Takemoto, T, Nakajima, R, Kanzaki, R, Okami, J, Kadota, Y, Hanaoka, N, Hayashi, A, Nishio, W, Takahashi, Y, Nakamura, H, Taniguchi, Y, Yamashina, A, Yamamoto, H, Miyata, Y, Matsuura, M, Tanaka, T, Matsuura, N, Suehisa, H, Chang, SS, So, T, Osaki, T, Takeo, S, Takenoyama, M, Miyazaki, T, Marutsuka, T, Yoshimoto, K, Kariatsumari, K & Yanagi, M 2017, 'Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation', Annals of Thoracic Surgery, vol. 103, no. 2, pp. 432-440. https://doi.org/10.1016/j.athoracsur.2016.08.077
Kitamura, Yoshitaka ; Suzuki, Kenji ; Teramukai, Satoshi ; Sonobe, Makoto ; Toyooka, Shinichi ; Nakagawa, Yoshihisa ; Yokomise, Hiroyasu ; Date, Hiroshi ; Arikura, J. ; Miyajima, M. ; Tsunooka, N. ; Ueda, S. ; Shiono, S. ; Ichimura, H. ; Ohtaki, Y. ; Kawashima, O. ; Takahashi, N. ; Iwata, T. ; Murakawa, T. ; Shimada, Y. ; Horio, H. ; Ishibashi, H. ; Kawachi, R. ; Omori, T. ; Naito, M. ; Hashimoto, T. ; Waseda, R. ; Tsunezuka, Y. ; Tanaka, N. ; Eguchi, T. ; Agatsuma, H. ; Mizuno, Y. ; Nishikawa, S. ; Isaka, M. ; Haneda, H. ; Narita, K. ; Okuda, K. ; Kobayashi, Y. ; Terada, Y. ; Takemoto, T. ; Nakajima, R. ; Kanzaki, R. ; Okami, J. ; Kadota, Y. ; Hanaoka, N. ; Hayashi, A. ; Nishio, W. ; Takahashi, Y. ; Nakamura, H. ; Taniguchi, Y. ; Yamashina, A. ; Yamamoto, H. ; Miyata, Y. ; Matsuura, M. ; Tanaka, T. ; Matsuura, N. ; Suehisa, H. ; Chang, S. S. ; So, T. ; Osaki, T. ; Takeo, S. ; Takenoyama, M. ; Miyazaki, T. ; Marutsuka, T. ; Yoshimoto, K. ; Kariatsumari, K. ; Yanagi, M. / Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation. In: Annals of Thoracic Surgery. 2017 ; Vol. 103, No. 2. pp. 432-440.
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title = "Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation",
abstract = "Background The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. Methods We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. Results Among the 1,254 patients, 902 (71.9{\%}) and 452 patients (36.0{\%}) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8{\%}) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4{\%}), 204 (16.3{\%}) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6{\%} (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. Conclusions Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.",
author = "Yoshitaka Kitamura and Kenji Suzuki and Satoshi Teramukai and Makoto Sonobe and Shinichi Toyooka and Yoshihisa Nakagawa and Hiroyasu Yokomise and Hiroshi Date and J. Arikura and M. Miyajima and N. Tsunooka and S. Ueda and S. Shiono and H. Ichimura and Y. Ohtaki and O. Kawashima and N. Takahashi and T. Iwata and T. Murakawa and Y. Shimada and H. Horio and H. Ishibashi and R. Kawachi and T. Omori and M. Naito and T. Hashimoto and R. Waseda and Y. Tsunezuka and N. Tanaka and T. Eguchi and H. Agatsuma and Y. Mizuno and S. Nishikawa and M. Isaka and H. Haneda and K. Narita and K. Okuda and Y. Kobayashi and Y. Terada and T. Takemoto and R. Nakajima and R. Kanzaki and J. Okami and Y. Kadota and N. Hanaoka and A. Hayashi and W. Nishio and Y. Takahashi and H. Nakamura and Y. Taniguchi and A. Yamashina and H. Yamamoto and Y. Miyata and M. Matsuura and T. Tanaka and N. Matsuura and H. Suehisa and Chang, {S. S.} and T. So and T. Osaki and S. Takeo and M. Takenoyama and T. Miyazaki and T. Marutsuka and K. Yoshimoto and K. Kariatsumari and M. Yanagi",
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TY - JOUR

T1 - Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation

AU - Kitamura, Yoshitaka

AU - Suzuki, Kenji

AU - Teramukai, Satoshi

AU - Sonobe, Makoto

AU - Toyooka, Shinichi

AU - Nakagawa, Yoshihisa

AU - Yokomise, Hiroyasu

AU - Date, Hiroshi

AU - Arikura, J.

AU - Miyajima, M.

AU - Tsunooka, N.

AU - Ueda, S.

AU - Shiono, S.

AU - Ichimura, H.

AU - Ohtaki, Y.

AU - Kawashima, O.

AU - Takahashi, N.

AU - Iwata, T.

AU - Murakawa, T.

AU - Shimada, Y.

AU - Horio, H.

AU - Ishibashi, H.

AU - Kawachi, R.

AU - Omori, T.

AU - Naito, M.

AU - Hashimoto, T.

AU - Waseda, R.

AU - Tsunezuka, Y.

AU - Tanaka, N.

AU - Eguchi, T.

AU - Agatsuma, H.

AU - Mizuno, Y.

AU - Nishikawa, S.

AU - Isaka, M.

AU - Haneda, H.

AU - Narita, K.

AU - Okuda, K.

AU - Kobayashi, Y.

AU - Terada, Y.

AU - Takemoto, T.

AU - Nakajima, R.

AU - Kanzaki, R.

AU - Okami, J.

AU - Kadota, Y.

AU - Hanaoka, N.

AU - Hayashi, A.

AU - Nishio, W.

AU - Takahashi, Y.

AU - Nakamura, H.

AU - Taniguchi, Y.

AU - Yamashina, A.

AU - Yamamoto, H.

AU - Miyata, Y.

AU - Matsuura, M.

AU - Tanaka, T.

AU - Matsuura, N.

AU - Suehisa, H.

AU - Chang, S. S.

AU - So, T.

AU - Osaki, T.

AU - Takeo, S.

AU - Takenoyama, M.

AU - Miyazaki, T.

AU - Marutsuka, T.

AU - Yoshimoto, K.

AU - Kariatsumari, K.

AU - Yanagi, M.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. Methods We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. Results Among the 1,254 patients, 902 (71.9%) and 452 patients (36.0%) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8%) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4%), 204 (16.3%) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6% (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. Conclusions Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.

AB - Background The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. Methods We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. Results Among the 1,254 patients, 902 (71.9%) and 452 patients (36.0%) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8%) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4%), 204 (16.3%) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6% (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. Conclusions Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.

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U2 - 10.1016/j.athoracsur.2016.08.077

DO - 10.1016/j.athoracsur.2016.08.077

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VL - 103

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EP - 440

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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