癌症诊断后缺血性中风风险:基于人口的匹配队列研究
Deborah M Siegal1, Joshua O Cerasuolo2, Marc Carrier1
1Department of Medicine, University of Ottawa, Ottawa, Canada; Inflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Canada.
Journal of thrombosis and haemostasis : JTH
|January 11, 2025
概括
没有先前中风的癌症患者在1.5年内患缺血性中风的风险更高. 风险因癌症的部位和阶段而异,在以前患有中风的人中没有观察到增加的风险.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 关于癌症和缺血性中风之间的关联存在有限的数据,特别是在有中风病史的患者中.
- 了解这种关系对于患者管理和风险分层至关重要.
研究的目的:
- 量化和比较被诊断患有癌症的个人与没有癌症的人的缺血性中风风险.
- 调查以前的中风病史如何影响癌症与缺血性中风的关联.
主要方法:
- 一项基于人口的匹配队列研究在加拿大安大略省进行,包括18岁及以上的成年人.
- 建立了两个队列:一个没有先前的缺血性中风,一个有先前的缺血性中风,癌症患者与年龄和性别的无癌症对照1:1匹配.
- 主要结局是缺血性中风的发病率,分区调整后的危险比率计算以考虑死亡作为竞争事件.
主要成果:
- 在没有先前中风的队列中,癌症患者 (n=620,647) 在1.5年 (4.6/1000人/年) 显示出较高的缺血性中风发病率,与对照组 (3.5/1000人/年) 相比,调整后的风险比率 (aHR) 为1.40.
- 在前患中风的队列中,癌症患者 (n=13,924) 和对照患者 (人年26.9/1000与22.0/1000) 之间,1.5年内缺血性中风的发生率相似,aHR为1.00.
- 从1.5年到5年,癌症患者的缺血性中风风险比两组对照患者低 (aHR分别为0.72和0.53).
结论:
- 被诊断为癌症且以前没有中风的个人在诊断后的最初1.5年内面临缺血性中风的风险增加.
- 癌症患者中风病史中缺血性中风的风险与以前中风的无癌症患者相比较.
- 癌症和缺血性中风风险之间的关联是动态的,在两个队列中观察到超过1.5年的风险降低.
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