静态药和心脏移植后的癌症风险
Georg Marcus Fröhlich1, Kaspar Rufibach, Frank Enseleit
1Cardiovascular Center Cardiology, Heart Failure/Transplantation Clinic, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. georg.froehlich@gmx.at
Circulation
|July 5, 2012
概括
心脏移植后的静止剂治疗显著降低了癌症风险,并改善了存活率. 这项研究表明,他类药物为移植受体提供了超越降脂的好处.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 在瘤学瘤学.
背景情况:
- 癌症仍然是心脏移植后晚期死亡的主要原因,尽管免疫抑制技术取得了进展.
- 类他类药物除了降脂之外,还具有潜在的类作用.
- 类药物治疗对移植后癌症风险和存活率的影响尚未完全理解.
研究的目的:
- 调查他类药物治疗与心脏移植后恶性瘤发生率之间的关联.
- 评估他类药物使用对心脏移植接受者的整体存活时间的影响.
主要方法:
- 对255名心脏移植患者的回顾性分析,这些患者在心脏移植后的第一年 (1985-2007) 幸存下来.
- 主要结局:任何恶性瘤的发生率. 二次结果:整体存活率.
- 考克斯回归分析调整了相关共变量,包括免疫抑制疗法.
主要成果:
- 达丁类药物使用与移植后8年瘤累积发病率降低有关 (13%对34%).
- 立方体治疗显著改善了无癌症存活率 (P<0.0001) 和整体存活率 (P<0.0001).
- 药物降低了67% (HR,0.33;95%CI,0.21-0.51;P<0.0001) 的恶性瘤的危险性.
结论:
- 静止剂的使用似乎与心脏移植后改善的无癌症和整体存活率有关.
- 这些发现表明,在心脏移植患者中,他类药物对恶性瘤的潜在保护作用.
- 需要进行前性试验来证实这些观察结果.
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