根据心脏手术患者的癌症状况,以患者为中心的结果:基于人口的队列研究
Habib Jabagi1,2, Joshua G Lee3, Osamu W Yasui4
1Division of Cardiothoracic Surgery, The Valley Hospital, Ridgewood, NJ, USA.
British journal of cancer
|March 17, 2026
概括
接受心脏手术的癌症患者面临与非癌症患者相似的风险. 特定的癌症类型,如血液和肺癌,可能会增加主要不良心血管事件 (MACE) 的风险.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 越来越多的癌症幸存者正在接受心脏手术.
- 心脏手术后癌症幸存者的术后结果尚未得到充分了解.
- 这项研究调查了接受心脏手术的癌症患者的主要不良心血管事件 (MACE) 和患者定义的心血管和非心血管事件 (PACE).
研究的目的:
- 确定心脏手术后癌症患者中MACE和PACE的发生率和预测因子.
- 为了比较癌症患者和接受心脏手术的非癌症患者之间的术后结果.
主要方法:
- 使用MarketScan和Medicare数据库 (2016-2022) 的回顾性队列研究.
- 包括美国成年人 (≥18岁) 接受心脏手术.
- 共同初级结局:MACE (中风,心力衰竭,心肌梗塞,重复血管化) 和PACE (中风,心力衰竭,新发性透析,长期护理入院,呼吸机依赖).
- 考克斯回归分析用于评估癌症状况与结果的关联.
主要成果:
- 该研究包括61581名患者,其中8.7%的患者被诊断患有癌症.
- 未经调整的分析显示,癌症患者的MACE和PACE水平较高.
- 多变量分析显示,癌症状况与30天或长期随访后的MACE或PACE之间没有显著的关联.
- 血液和肺癌与MACE风险增加有关.
- 消化和血液癌症与更高的PACE风险有关.
- 高龄,女性性别和复杂的手术是PACE的更强的预测因素,而不是MACE.
结论:
- 癌症状况本身不应该成为心脏手术的禁忌.
- 建议采用个性化,多学科的方法,以优化心脏手术的癌症患者的结果和风险管理.
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