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主观步态速度与 56589 例癌症幸存者发生心血管事件风险的关系。

Subjective Gait Speed and Risk of Developing Cardiovascular Events in 56,589 Cancer Survivors.

机构信息

Department of Cardiovascular Medicine, The University of Tokyo.

Department of Advanced Cardiology, The University of Tokyo.

出版信息

Int Heart J. 2023;64(4):672-677. doi: 10.1536/ihj.22-728.

Abstract

Despite having a higher risk of cardiovascular disease (CVD), there are currently limited data for stratifying CVD risk among cancer survivors. The purpose of this study was to uncover the relationship of subjective gait speed with incident CVD among cancer survivors.This retrospective observational cohort study analyzed data from the JMDC Claims Database between 2005 and 2021 including 56,589 patients with a prior history of breast, colorectal, or stomach cancer but no history of CVD. Gait speed was evaluated using information from self-reported questionnaires collected during health checkups. The primary endpoint was composite CVD outcome, which included heart failure, myocardial infarction, angina pectoris, and stroke.The median (interquartile range) age was 54 (48-61) years, and 20,981 (37.1%) were male. Among them, 25,933 patients (45.8%) reported fast gait speed. During a mean follow-up period of 1002 ± 803 days, 3,221 composite CVD outcomes were recorded. In multivariate Cox regression analysis, slow gait speed was associated with a higher risk of developing CVD compared with fast gait speed (hazard ratio, 1.14, 95% confidence interval, 1.06-1.22). This association was consistent across a variety of sensitivity analyses.We demonstrated that subjective slow gait speed was associated with a greater risk of CVD development among cancer survivors. This suggests the potential value of gait speed assessment for the CVD risk stratification of cancer patients as well as the clinical importance of maintaining exercise capacity among patients living with cancer.

摘要

尽管癌症幸存者患心血管疾病(CVD)的风险较高,但目前用于评估 CVD 风险的相关数据有限。本研究旨在揭示主观步态速度与癌症幸存者 CVD 发病之间的关系。

本回顾性观察性队列研究分析了 2005 年至 2021 年期间 JMDC 理赔数据库中的数据,纳入了 56589 例既往有乳腺癌、结直肠癌或胃癌病史但无 CVD 病史的患者。通过健康检查期间收集的自我报告问卷评估步态速度。主要终点是复合 CVD 结局,包括心力衰竭、心肌梗死、心绞痛和中风。

中位(四分位间距)年龄为 54(48-61)岁,20981 例(37.1%)为男性。其中,25933 例(45.8%)患者报告了较快的步态速度。在平均 1002±803 天的随访期间,记录了 3221 例复合 CVD 结局。多变量 Cox 回归分析显示,与快速步态速度相比,缓慢步态速度与 CVD 发病风险增加相关(风险比,1.14;95%置信区间,1.06-1.22)。这种关联在各种敏感性分析中均一致。

我们证明了主观步态速度较慢与癌症幸存者 CVD 发病风险增加相关。这表明步态速度评估可能对癌症患者的 CVD 风险分层具有潜在价值,以及维持癌症患者运动能力的临床重要性。

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