Yin Xuejiao, Fan Fengjuan, Zhang Bo, Hu Yu, Sun Chunyan
Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China.
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ther Adv Hematol. 2022 Mar 31;13:20406207221086755. doi: 10.1177/20406207221086755. eCollection 2022.
Multiple myeloma (MM) survival has greatly improved in recent decades. MM is usually diagnosed at a median age of 66-70 years. MM patients do not necessarily die from primary cancer, so cardiovascular health may be a key factor threatening long-term survival. This study was designed to explore the cardiovascular disease mortality (CVM) trends in MM patients and compare them with those in the general population.
In total, 88,328 MM patients from the Surveillance, Epidemiology, and End Results (SEER) database (1975-2016) were included. Standardized mortality ratios (SMRs) were used to assess CVM risk.
The CVM risk was significantly higher in MM patients than in the general population (SMR, 1.84 (95% CI, 1.78-1.89)). MM patients had the highest CVM SMR, at 2.62 (95% CI, 2.49-2.75), in the first year after diagnosis, and it decreased over the follow-up period. Over the study period, the incidence of CVM continued to decrease in MM patients diagnosed at age 65-74 (APC, -1.2% (95% CI, -1.9% to -0.4%)) and ⩾75 years (APC, -1.9% (95% CI, -2.6% to -1.2%)) but not younger. CVM was the second-most common cause of death in patients ⩾75 years. In only MM case analyses, male sex, Black race, older age at diagnosis, and earlier year of diagnosis were poor prognostic factors for heart-specific mortality.
The CVM risk in MM patients was significantly higher than that in the general population. To improve survival, cardiovascular health should receive attention upon diagnosis.
近几十年来，多发性骨髓瘤（MM）患者的生存率有了显著提高。MM通常在66至70岁的中位年龄被诊断出来。MM患者不一定死于原发性癌症，因此心血管健康可能是威胁长期生存的关键因素。本研究旨在探讨MM患者的心血管疾病死亡率（CVM）趋势，并将其与普通人群进行比较。
共纳入了监测、流行病学和最终结果（SEER）数据库（1975 - 2016年）中的88328例MM患者。采用标准化死亡率比（SMR）来评估CVM风险。
MM患者的CVM风险显著高于普通人群（SMR，1.84（95%CI，1.78 - 1.89））。MM患者在诊断后的第一年CVM SMR最高，为2.62（95%CI，2.49 - 2.75），且在随访期间有所下降。在研究期间，65 - 74岁（APC，-1.2%（95%CI，-1.9%至-0.4%））和≥75岁（APC，-1.9%（95%CI，-2.6%至-1.2%））诊断的MM患者中CVM发病率持续下降，但年轻患者中并非如此。CVM是≥75岁患者中第二常见的死亡原因。仅在MM病例分析中，男性、黑人种族、诊断时年龄较大和诊断年份较早是心脏特异性死亡率的不良预后因素。
MM患者的CVM风险显著高于普通人群。为提高生存率，诊断时应关注心血管健康。
