Loprinzi P D
Department of Health, Exercise Science and Recreation Management, Jackson Heart Study Vanguard Center of Oxford, Center for Health Behavior Research, The University of Mississippi, University, MS, USA.
Int J Clin Pract. 2016 Aug;70(8):691-5. doi: 10.1111/ijcp.12840. Epub 2016 Jul 7.
The American College of Cardiology/American Heart Association Task Force on Practice Guidelines recently developed the Pooled Cohort Risk (PCR) equations to predict 10-years risk for a first atherosclerotic cardiovascular disease (ASCVD) event. The predictive validity of these PCR equations on cancer-specific mortality among a national sample of US adults has yet to be evaluated, which was this study's purpose.
Data from the 1999-2010 National Health and Nutrition Examination Survey were used, with participants followed through December 31, 2011 to ascertain cancer mortality status via the National Death Index probabilistic algorithm. The analysed sample included 11,171 CVD-free adults (40-79 years). Ten-year risk of a first ASCVD was determined from the PCR equations.
For the entire sample, 849,202 person-months occurred with an incidence rate of 0.31 cancer-specific deaths per 1,000 person-months. The unweighted follow-up duration was 72 months (IQR = 39-114). After adjusting for age, gender, race-ethnicity, physical activity and obesity, those with an elevated ASCVD (≥ 7.5%) whom did not have a history of cancer at baseline had a 71% increased risk of cancer-specific mortality. There was less evidence for this relationship among those with a history of cancer. The individual components of the ASCVD that were predictive of cancer-specific mortality included age and smoking status.
Ten-year predicted risk of a first ASCVD event via the PCR equations were significantly associated with cancer-specific mortality in a national sample of US adults (40-79 years) whom were free of cancer and CVD at baseline. In this American adult sample, the PCR equations provide evidence of predictive validity for cancer-specific mortality, particularly among those without cancer.
美国心脏病学会/美国心脏协会实践指南工作组最近制定了汇总队列风险（PCR）方程，以预测首次发生动脉粥样硬化性心血管疾病（ASCVD）事件的10年风险。这些PCR方程在美国成年人全国样本中对癌症特异性死亡率的预测有效性尚未得到评估，这是本研究的目的。
使用了1999 - 2010年国家健康和营养检查调查的数据，参与者随访至2011年12月31日，通过国家死亡指数概率算法确定癌症死亡状态。分析样本包括11171名无心血管疾病的成年人（40 - 79岁）。通过PCR方程确定首次发生ASCVD的10年风险。
对于整个样本，共发生了849202人月，癌症特异性死亡率为每1000人月0.31例。未加权的随访时间为72个月（四分位间距 = 39 - 114）。在调整年龄、性别、种族、身体活动和肥胖因素后，基线时无癌症病史且ASCVD风险升高（≥7.5%）的人群癌症特异性死亡风险增加71%。在有癌症病史的人群中，这种关系的证据较少。预测癌症特异性死亡率的ASCVD个体成分包括年龄和吸烟状况。
通过PCR方程预测的首次ASCVD事件的10年风险与美国成年人（40 - 79岁）全国样本中的癌症特异性死亡率显著相关，这些成年人在基线时无癌症和心血管疾病。在这个美国成年人样本中，PCR方程为癌症特异性死亡率提供了预测有效性的证据，特别是在无癌症的人群中。
