Li Jinjing, Zhao Jieqiong, Lei Yonghong, Chen Yan, Cheng Miaomiao, Wei Xiaoqing, Liu Jing, Liu Pengyun, Chen Ruirui, Yin Xiaoqing, Shang Lei, Li Xue
Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Department of Plastic Surgery, Chinese PLA General Hospital, Beijing, China.
Front Cardiovasc Med. 2022 Apr 7;9:821267. doi: 10.3389/fcvm.2022.821267. eCollection 2022.
In our clinical work, we found that cancer patients were susceptible to coronary atherosclerotic heart disease (CAD). However, less is known about the relationship between CAD and cancer. The present study aimed to identify the risk factors for CAD and cancer, as well as the relationship between CAD and cancer.
In this retrospective study, 1600 patients between January 2012 and June 2019 were enrolled and divided into groups according to whether they had CAD or cancer. Single-factor and multivariate analysis methods were applied to examine the risk factors for CAD and cancer.
(1) Cancer prevalence was significantly higher in patients with CAD than in patients without CAD (47.2 vs. 20.9%). The prevalence of CAD in cancer and non-cancer patients was 78.9 and 52.4%, respectively. (2) Multivariable logistic regression showed that patients with cancer had a higher risk of developing CAD than non-cancer patients (OR: 2.024, 95% CI: 1.475 to 2.778, < 0.001). Respiratory (OR: 1.981, 95% CI: 1.236-3.175, = 0.005), digestive (OR: 1.899, 95% CI: 1.177-3.064, = 0.009) and urogenital (OR: 3.595, 95% CI: 1.696-7.620, = 0.001) cancers were significantly associated with a higher risk of CAD compared with no cancer. (3) Patients with CAD also had a higher risk of developing cancer than non-CAD patients (OR = 2.157, 95% CI: 1.603 to 2.902, < 0.001). Patients in the Alanine aminotransferase (ALT) level ≥ 40 U/L group had a lower risk of cancer than patients in the ALT level < 20 U/L group (OR: 0.490, 95% CI: 0.333-0.722, < 0.001). (4) An integrated variable (Y = 0.205 × 10 age - 0.595 × 10 HGB - 0.116 × 10 ALT + 0.135 FIB) was identified for monitoring the occurrence of cancer among CAD patients, with an AUC of 0.720 and clinical sensitivity/specificity of 0.617/0.711.
(1) We discovered that CAD was an independent risk factor for cancer and vice versa. (2) Digestive, respiratory and urogenital cancers were independent risk factors for CAD. (3) We created a formula for the prediction of cancer among CAD patients. (4) ALT, usually considered a risk factor, was proven to be a protective factor for cancer in this study.
在我们的临床工作中，我们发现癌症患者易患冠状动脉粥样硬化性心脏病（CAD）。然而，关于CAD与癌症之间的关系，人们了解较少。本研究旨在确定CAD和癌症的危险因素，以及CAD与癌症之间的关系。
在这项回顾性研究中，纳入了2012年1月至2019年6月期间的1600例患者，并根据他们是否患有CAD或癌症进行分组。采用单因素和多因素分析方法来研究CAD和癌症的危险因素。
（1）CAD患者的癌症患病率显著高于无CAD患者（47.2%对20.9%）。癌症患者和非癌症患者中CAD的患病率分别为78.9%和52.4%。（2）多变量逻辑回归显示，癌症患者发生CAD的风险高于非癌症患者（比值比：2.024，95%置信区间：1.475至2.778，P<0.001）。与无癌症相比，呼吸系统（比值比：1.981，95%置信区间：1.236 - 3.175，P = 0.005）、消化系统（比值比：1.899，95%置信区间：1.177 - 3.064，P = 0.009）和泌尿生殖系统（比值比：3.595，95%置信区间：1.696 - 7.620，P = 0.001）癌症与CAD发生风险显著相关。（3）CAD患者发生癌症的风险也高于非CAD患者（比值比 = 2.157，95%置信区间：1.603至2.902，P<0.001）。丙氨酸氨基转移酶（ALT）水平≥40 U/L组的患者患癌症的风险低于ALT水平<20 U/L组的患者（比值比：0.490，95%置信区间：0.333 - 0.722，P<0.001）。（4）确定了一个综合变量（Y = 0.205×10年龄 - 0.595×10血红蛋白 - 0.116×10 ALT + 0.135纤维蛋白原）用于监测CAD患者中癌症的发生，曲线下面积为0.720，临床敏感性/特异性为0.617/0.711。
（1）我们发现CAD是癌症的独立危险因素，反之亦然。（2）消化、呼吸和泌尿生殖系统癌症是CAD的独立危险因素。（3）我们创建了一个用于预测CAD患者中癌症的公式。（4）ALT通常被认为是一个危险因素，但在本研究中被证明是癌症的保护因素。
