癌症病史对行经皮缘对缘二尖瓣修复术患者临床结局的影响。
Impact of cancer history on clinical outcome in patients undergoing transcatheter edge-to-edge mitral repair.
机构信息
Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
出版信息
Clin Res Cardiol. 2021 Mar;110(3):440-450. doi: 10.1007/s00392-020-01770-2. Epub 2020 Nov 9.
BACKGROUND
Little is known about the prevalence of a history of cancer and its impact on clinical outcome in mitral regurgitation (MR) patients undergoing transcatheter mitral valve repair (TMVR).
OBJECTIVES
The purpose of this study is to investigate the prevalence of cancer, baseline inflammatory parameters, and clinical outcome in MR patients undergoing TMVR.
METHODS
Consecutive patients undergoing a MitraClip procedure were enrolled, and the patients were stratified into two groups: cancer and non-cancer. Baseline complete blood counts (CBC) with differential hemograms were collected prior to the procedure to calculate the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). All-cause death within a one-year was examined.
RESULTS
In total, 82 out of 446 patients (18.4%) had a history of cancer. Cancer patients had a significantly higher baseline PLR [181.4 (121.1-263.9) vs. 155.4 (109.4-210.4); P = 0.012] and NLR [5.4 (3.5-8.3) vs. 4.0 (2.9-6.1); P = 0.002] than non-cancer patients. A Kaplan-Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer (estimated 1-year mortality, 20.2 vs. 9.2%; log-rank P = 0.009), and multivariable analyses of three models showed that cancer history was an independent factor for 1-year mortality. Patients who died during follow-up had a significantly higher baseline PLR [214.2 (124.2-296.7) vs. 156.3 (110.2-212.1); P = 0.007] and NLR [6.4 (4.2-12.5) vs. 4.0 (2.9-6.2); P < 0.001] than survivors.
CONCLUSIONS
In MitraClip patients, a history of cancer was associated with higher inflammatory parameters and worse prognosis compared to non-cancer patients. Central Illustration. Clinical outcomes and baseline PLR and NLR values accord-ing to one-year mortality. (Left) Patients who died within the follow-up period had a significantly higher baseline PLR (214.2 [124.2-296.7] vs 156.3 [110.2-212.1]; P = 0.007) and NLR (6.4 [4.2-12.5] vs 4.0 [2.9-6.2]; P < 0.001) than patients who survived. PLR, platelet-to-lymphocyte ratio; NLR, neutrophil-to-lymphocyte ratio (Right) A Kaplan-Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer patients (estimated one-year mortality, 20.2 vs 9.2%; log-rank P = 0.009).
背景
在接受经导管二尖瓣修复术（TMVR）的二尖瓣反流（MR）患者中，癌症病史的流行情况及其对临床结局的影响知之甚少。
目的
本研究旨在调查接受 TMVR 的 MR 患者的癌症患病率、基线炎症参数和临床结局。
方法
连续纳入接受 MitraClip 手术的患者，并将患者分为两组：癌症和非癌症。在手术前收集完整的血细胞计数（CBC）和差异血球计数，以计算血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）。检查一年内的全因死亡情况。
结果
总共 446 例患者中有 82 例（18.4%）有癌症病史。癌症患者的基线 PLR [181.4（121.1-263.9）比 155.4（109.4-210.4）；P=0.012]和 NLR [5.4（3.5-8.3）比 4.0（2.9-6.1）；P=0.002]明显更高。Kaplan-Meier 分析显示，癌症患者的预后明显差于非癌症患者（估计 1 年死亡率，20.2%比 9.2%；对数秩 P=0.009），三个模型的多变量分析显示，癌症病史是 1 年死亡率的独立因素。随访期间死亡的患者的基线 PLR [214.2（124.2-296.7）比 156.3（110.2-212.1）；P=0.007]和 NLR [6.4（4.2-12.5）比 4.0（2.9-6.2）；P<0.001]明显高于幸存者。
结论
在接受 MitraClip 治疗的患者中，与非癌症患者相比，癌症病史与更高的炎症参数和更差的预后相关。临床结果和根据一年死亡率的基线 PLR 和 NLR 值。（左）随访期间死亡的患者的基线 PLR（214.2[124.2-296.7]比 156.3[110.2-212.1]；P=0.007）和 NLR（6.4[4.2-12.5]比 4.0[2.9-6.2]；P<0.001）明显高于存活的患者。PLR，血小板与淋巴细胞比值；NLR，中性粒细胞与淋巴细胞比值（右）Kaplan-Meier 分析显示，癌症患者的预后明显差于非癌症患者（估计 1 年死亡率，20.2%比 9.2%；对数秩 P=0.009）。
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