心脏学参数预测瘤患者的死亡率和心脏毒性
Sebastian W Romann1,2, Daniel Finke1,2, Markus B Heckmann1,2
1Department of Internal Medicine III: Cardiology, Angiology and Pulmonology, Cardio-Oncology Unit, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
ESC heart failure
|November 27, 2023
概括
在癌症患者中,心脏生物标志物如hs-cTnT和NT-proBNP的升高预测了全因死亡率 (ACM). 心血管风险因素 (CVRF) 预测心脏毒性,建议针对癌症患者进行量身定制的监测.
科学领域:
- 心脏瘤学 - 心脏瘤学
- 生物标志物研究的研究.
- 在瘤学瘤学.
背景情况:
- 癌症患者需要加强对心脏有毒性的心脏监测.
- 心脏生物标志物和患者风险因素对结果的预测价值至关重要.
研究的目的:
- 研究心脏生物标志物 (hs-cTnT,NT-proBNP) 和风险因素 (年龄,CVRF,心脏功能) 以预测癌症患者的全因死亡率 (ACM) 和心脏毒性.
- 评估这些因素在风险分层中对定制监测的有用性.
主要方法:
- 对1971年入院心脏瘤病房的癌症患者进行了回顾性分析.
- 评估包括病史,体检,心电图,心声图和心脏生物标志物 (hs-cTnT,NT-proBNP).
- 主要终点:ACM;次要终点:心脏毒性 (ESC定义).
主要成果:
- Hs-cTnT (≥7 ng/L) 和NT-proBNP是ACM的独立预测因子 (分别为OR1.82,P<0.001和OR1.98,P<0.001).
- 减少左心室喷射分数没有预测ACM (P=0.85).
- 多次CVRF确定了高风险患者 (n=886) 患有心脏毒性风险增加 (11.3%,HR 1.57,P=0.004) 和基线hs-cTnT/NT-proBNP升高.
结论:
- CVRF积累预测癌症患者的心脏毒性.
- 升高的hs-cTnT或NT-proBNP水平与ACM有关.
- 对于心脏生物标志物低且没有CVRFs的患者,可能适合较少密集的监测.
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