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基于全国人口的关于恶性肿瘤患者急性冠状动脉综合征关联的队列研究。

Nationwide population-based cohort study on the association of acute coronary syndrome in patients with malignancies.

作者信息

Lin Yen-Nien, Chang Yen-Jung, Chen Yin-Huei, Ko Po-Yen, Lin Cheng-Li, Sung Fung-Chang, Chang Kuan-Cheng, Kao Chia-Hung

机构信息

Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

出版信息

Support Care Cancer. 2014 Oct;22(10):2707-13. doi: 10.1007/s00520-014-2262-8. Epub 2014 May 4.

Abstract

AIMS/INTRODUCTION: Patients with malignancy are suggestive of having a tendency toward an association with vascular thrombosis risk. The aim of this study was to evaluate the possible relationship between malignancy and the risk of acute coronary syndrome (ACS) in Taiwan.

MATERIALS AND METHODS

We used data from the National Health Insurance (NHI) system of Taiwan to assess the issue. Cox proportional hazards regression analysis was conducted to estimate the effects of malignancy on the risk of ACS.

RESULTS

ACS risk in patients with malignancies was marginally significantly greater when adjusted for age, sex (hazard ratio (HR) = 1.09, 95 % confidence interval (CI) = 0.99-1.20), and comorbidities (HR = 1.03, 95 % CI = 0.93-1.13). A subgroup analysis indicated that patients with prostate cancer and head and neck cancer (HEENT) had a significantly higher risk of ACS (HR = 1.30, 95 % CI = 1.01-1.67; HR = 3.03, 95 % CI = 1.47-6.50).

CONCLUSIONS

We suggest careful surveillance of ACS symptoms and regular electrocardiography during follow-up of these patients. However, further large-scale studies for patients with prostate and HEENT cancer and cancer survivors (especially from post-hormone or radiotherapy) are needed.

摘要

目的/引言:恶性肿瘤患者提示有血管血栓形成风险增加的倾向。本研究旨在评估台湾地区恶性肿瘤与急性冠状动脉综合征(ACS)风险之间的可能关系。

材料与方法

我们使用台湾地区国民健康保险(NHI)系统的数据来评估该问题。进行Cox比例风险回归分析以估计恶性肿瘤对ACS风险的影响。

结果

在对年龄、性别(风险比(HR)=1.09,95%置信区间(CI)=0.99 - 1.20)和合并症进行调整后,恶性肿瘤患者的ACS风险略显著增加(HR = 1.03,95% CI = 0.93 - 1.13)。亚组分析表明,前列腺癌和头颈部癌(HEENT)患者的ACS风险显著更高(HR = 1.30,95% CI = 1.01 - 1.67;HR = 3.03,95% CI = 1.47 - 6.50)。

结论

我们建议在这些患者的随访期间仔细监测ACS症状并定期进行心电图检查。然而,需要对前列腺癌和头颈部癌患者以及癌症幸存者(特别是激素治疗或放疗后的患者)进行进一步的大规模研究。

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