Author + information
- Received April 24, 2020
- Revision received July 23, 2020
- Accepted August 3, 2020
- Published online September 21, 2020.
- So Ree Kim, MDa,
- Eun Kyoung Kim, MD, PhDb,∗ (, )@EunKyoungKim10,
- Jinhyun Cho, MDc,
- Sung-A Chang, MD, PhDb,
- Sung-Ji Park, MD, PhDb,
- Sang-Chol Lee, MD, PhDb and
- Seung Woo Park, MD, PhDb
- aDivision of Cardiology, Department of Internal Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- bDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- cDivision of Hematology-Oncology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- ↵∗Address for correspondence:
Dr. Eun Kyoung Kim, Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
Background Pericardiocentesis (PCC) with extended catheter drainage has become a relatively safe procedure to control pericardial effusion (PE), but little is known about long-term outcomes after PCC in malignant PE.
Objectives This study evaluated the effects of anti-inflammatory agents on long-term outcomes after effective drainage of PE in active cancer patients.
Methods From May 2007 to December 2018, 445 patients with malignant PE who underwent echocardiography-guided PCC were enrolled. Clinical, laboratory, echocardiographic and procedural findings, and clinical outcome data were collected. Use of anti-inflammatory agents including colchicine, nonsteroidal anti-inflammatory drugs, or steroids after PCC was also analyzed. Colchicine was administered in a dose of 0.6 mg orally, twice a day for 2 months. The primary outcome was defined as a composite of all-cause death and re-PCC or pericardial window operation due to recurred PE.
Results The procedure was successful in 97.0% of the cases, with 1 procedure-related death. During the follow-up of 2 years, 26.1% of patients developed recurrent PE, and 46.0% developed constrictive pericarditis. The colchicine treatment group showed a significantly lower risk of composite events (adjusted hazard ratio [aHR]: 0.65; 95% confidence interval [CI]: 0.49 to 0.87; p = 0.003) as well as all-cause death (aHR: 0.60; 95% CI: 0.45 to 0.81; p = 0.001) than did the noncolchicine group. On propensity score matching, colchicine after PCC was consistently associated with a lower composite events (aHR: 0.55; 95% CI: 0.37 to 0.82; p = 0.003).
Conclusions In cancer patients with malignant PE, PCC with extended drainage can be an appropriate therapeutic option and shows low complication rate. Patients receiving colchicine after successful PCC showed significant improvement in clinical outcome.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received April 24, 2020.
- Revision received July 23, 2020.
- Accepted August 3, 2020.
- 2020 American College of Cardiology Foundation
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