JCO：成人发病癌症存活者的心血管疾病风险

2016-06-14 佚名环球医学

既往研究表明，青少年癌症生存者有较高的心血管疾病风险。2016年4月，发表在《J Clin Oncol》的一项研究对成年发病（≥40岁）癌症长期存活者的心血管疾病风险进行分析。　　目的：包括缺血性心脏病、卒中、心衰在内的心血管疾病（CVDs）是儿童和青中年（诊断时小于40岁）癌症存活者治疗的晚期影响。但是，成年发病（≥40岁）癌症长期存活者的CVD是未知的。　　方法：在一个大型综合医疗管理组织中，

既往研究表明，青少年癌症生存者有较高的心血管疾病风险。2016年4月，发表在《J Clin Oncol》的一项研究对成年发病（≥40岁）癌症长期存活者的心血管疾病风险进行分析。
　　

目的：包括缺血性心脏病、卒中、心衰在内的心血管疾病（CVDs）是儿童和青中年（诊断时小于40岁）癌症存活者治疗的晚期影响。但是，成年发病（≥40岁）癌症长期存活者的CVD是未知的。
　　

方法：在一个大型综合医疗管理组织中，回顾性队列研究设计用于描述36232名成年发病的存活≥2年的癌症患者和73545名配对（年龄、性别、居住地邮编）的非癌症对照者的CVD风险大小。多变量回归用于检测癌症存活者中，心血管风险因素（CVRFs：高血压、糖尿病、血脂异常）对长期CVD风险的影响。
　　

结果：与非癌症对照相比，多发性骨髓瘤（发病率比（IRR），1.70；P＜0.01）、肺癌/支气管癌（IRR，1.58；P＜0.01）、非霍奇金淋巴瘤（IRR，1.41；P＜0.01）、乳腺癌（IRR，1.13；P＜0.01）的存活者具有显著性高的CVD风险。相反，与对照相比，前列腺癌存活者具有较低的CVD风险（IRR，0.89；P＜0.01）。与具有少于两个CVRFs的非癌症对照相比，具有两个或多个CVRFs的癌症存活者具有较高的CVD风险（IRR，1.83～2.59；P＜0.01）。与没有CVD的癌症存活者（81%）相比，已经进展CVD的癌症存活者（60%），其8年总生存率显著性低（P＜0.01）。
　　

结论：随着癌症亚型和是否存在CVRFs，成年发病的癌症存活者的后续CVD风险的大小存在差异。已经进展CVD的存活者的总生存率较差，这意味着需要对具有最高的进展为CVD风险的个体进行有针对性的预防策略。

原始出处：

Armenian SH, Xu L, Ky B, Sun C, Farol LT, Pal SK, Douglas PS, Bhatia S, Chao C.Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study. J Clin Oncol. 2016 Apr 1;34(10):1122-30. doi: 10.1200/JCO.2015.64.0409. Epub 2016 Feb 1.

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2016-06-16 花花1368

#疾病风险#

67 0
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2016-06-16 andy2090

#血管疾病#

62 0
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2016-06-16 jetleo

多变量回归用于检测癌症存活者中，心血管风险因素（CVRFs：高血压、糖尿病、血脂异常）对长期CVD风险的影响。

137 0
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2016-08-14 lidong40

#JCO#

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