在不同类型的癌症中,风险概况和心血管事件的发生率
J D Mitchell1, M Laurie2, Q Xia2
1Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, USA; International Cardio-Oncology Society, Tampa, USA.
ESMO open
|November 18, 2023
概括
癌症幸存者面临更高的心血管风险,肺癌和骨髓瘤患者经历了最严重的心血管不良事件 (MACE). 了解这些风险有助于制定有针对性的预防策略,以获得更好的患者结果.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 流行病学 流行病学
背景情况:
- 癌症幸存者对心血管疾病的风险较高.
- 在不同类型的癌症中,心血管事件的特定发病率需要进一步调查.
研究的目的:
- 在多种癌症类型的诊断后,描述主要不良心血管事件 (MACE) 和心力衰竭 (HF) 的发生率.
- 为了比较不同恶性瘤的MACE发病率,根据基线心血管风险因素进行调整.
主要方法:
- 利用美国总部的行政索赔数据库,为839934名在2011-2019年间被诊断患有乳腺,肺,前列腺,黑色素瘤,骨髓瘤,脏,结肠直肠,白血病或淋巴瘤癌的患者提供数据.
- 评估了基线心血管风险因素,并计算了MACE (心肌梗塞,中风,心痛不稳定) 和HF的发病率.
- 采用多变量Cox危险模型来评估累积MACE发病率,控制基线风险因素.
主要成果:
- 在所有研究的癌症类型中,心血管风险因素普遍存在.
- 肺癌和骨髓瘤显示MACE的累积发病率最高,而乳腺癌,前列腺癌和黑色素瘤的累积发病率最低.
- 在诊断后4年,肺癌患者的MACE发病率比乳腺癌患者高2.7倍. 脑卒中发生率在肺癌中尤为高,HF发生率在骨髓瘤和肺癌中最高.
结论:
- 在特定的癌症诊断后,观察到心血管事件的显著增加,独立于基线风险因素.
- 癌症类型之间的患者特征和相关心血管风险的变化需要针对风险因素修改的量身定制策略.
- 开发有针对性的干预措施可以最大限度地减少不良心血管事件,并提高癌症幸存者的长期结果.
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