使用标准心血管风险计算器预测光胺化学疗法的心血管事件
Aderonke Abiodun1,2, Marianne Shawe-Taylor1, Sara Tyebally1,2,3
1Barts Heart Centre, Barts Health NHS Trust, London, UK.
ESC heart failure
|June 7, 2024
概括
皮里米丁化学疗法可能会导致心脏毒性. 高BMI和β抑制剂的使用与治疗期间的心血管事件有关,这表明QRISK3得分可能有助于识别有风险的患者.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 烯胺类化学疗法是固体瘤的关键治疗方法,但具有心脏毒性风险.
- 皮里米丁相关心脏毒性 (FAC) 与传统心血管 (CV) 风险因素之间的关联尚未得到充分理解.
- 标准CV风险得分没有被验证用于预测FAC.
研究的目的:
- 调查常规心血管风险因素与胺相关心脏毒性 (FAC) 之间的关系.
- 评估QRISK3得分在识别患有FAC风险的患者中的有用性.
- 分析在经历心血管事件后重新接受皮里米丁化疗的患者的结局.
主要方法:
- 对1898名用胺化疗治疗的患者电子健康记录的回顾性分析.
- 计算QRISK3分数以评估基线心血管风险.
- 考克斯回归分析以确定心血管风险因素,癌症治疗和FAC之间的关联.
- 在治疗后3个月内由心血管事件定义的FAC.
主要成果:
- 3.1%的患者在皮里米丁治疗期间或3个月内发生心血管事件 (心房痛,心房动).
- 在单变量分析中,QRISK3分数>20%与事件FAC有显著的关联.
- 在多变量分析中,更高的BMI和β-阻断剂使用独立地与发生的CV事件有关.
- 在6%的患者中,用光皮里米丁化疗重新挑战导致了重复的CV事件.
结论:
- 升高的BMI和β-阻断剂的使用是皮里米丁化疗期间心血管事件的危险因素.
- QRISK3得分显示了识别FAC风险较高的患者的潜力.
- 在某些特定情况下,在之前的CV事件后,重新挑战用氧胺化疗的患者似乎是安全的.
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