系统治疗后癌症幸存者的心血管疾病风险:基于人口的队列研究
Frits I Mulder1, Erzsébet Horváth-Puhó2, Nick van Es3
1Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Tergooi Hospitals, Hilversum, the Netherlands; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
JACC. CardioOncology
|June 19, 2025
概括
癌症幸存者在全身癌症治疗后面临心力衰竭,血栓和功能衰竭的风险增加. 这些心血管疾病的风险因癌症类型和接受的特定治疗而异.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 癌症患者在诊断后短期心血管疾病 (CVD) 风险较高.
- 关于癌症幸存者的长期心血管疾病风险的数据有限.
研究的目的:
- 为了估计癌症幸存者治疗全身疗法的心血管疾病的长期风险.
- 根据癌症类型和治疗来研究心血管疾病风险的变化.
主要方法:
- 丹麦人口登记册用于识别癌症幸存者和匹配的对照.
- 治疗后长达5年的随访时间.
- 考克斯回归分析调整以考虑混因素.
主要成果:
- 癌症幸存者患心力衰竭/心肌病 (HR 1.08),静脉血栓栓塞 (HR 1.50),心周炎/内心炎/心肌炎 (HR 1.30) 和功能衰竭 (HR 1.17) 的风险增加.
- 没有观察到缺血性心脏病,中风或心房动的风险增加.
- 风险因癌症类型和治疗而异;静脉血栓栓塞的风险普遍存在,而缺血性心脏病的风险仅在肺癌幸存者中升高.
结论:
- 系统性癌症治疗与幸存者的几种心血管疾病风险增加有关.
- 根据癌症类型和治疗剂,心血管疾病风险存在显著的异质性.
相关概念视频
Cancer Survival Analysis
458
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
458
Cancer Prevention
6.3K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
6.3K
Coronary Artery Disease IV: Preventive Measures
39
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
39
Treatment Resistant Cancers
3.4K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.4K
Relative Risk
366
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
366
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
353
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
353


