冠心病患者中癌症死亡的比例和数量。
Proportion and number of incident cancer deaths in coronary artery disease.
机构信息
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Southern Medical University, Guangzhou, China.
Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
出版信息
Cancer Med. 2023 Oct;12(19):20140-20149. doi: 10.1002/cam4.6595. Epub 2023 Sep 27.
BACKGROUND
Globally, coronary artery disease (CAD) and cancer are the leading causes of death. Studies focusing on the proportion and spectrum of cancer mortality among CAD patients are lacking. We aim to characterize the proportion and spectrum of cancer-specific mortality among patients with CAD.
METHODS
We analyzed 93,797 hospitalized survivors with angiographically documented CAD between 2007 and 2020 (mean age: 62.8 ± 11.1 years, 24.7% female) from Cardiorenal ImprovemeNt II (CIN-II) cohort.
RESULTS
During the median follow-up of 4.8 years (IQR: 2.6-7.5), 13,162 (14.0%) patients died after discharge. A total of 1223/7703 (15.8% of cause-specific death) CAD patients died of cancer. The three most common types of cancer-specific death were lung (36.1%), liver (13.3%), and colorectum cancer (12.8%). Furthermore, male (adjusted HR 2.38, 95% CI: 1.99-2.85) and older (≥60 vs. <60 years, adjusted HR 3.25, 95%CI 2.72-3.88) patients had a significantly increased cancer-specific mortality.
CONCLUSIONS
Our data suggest that nearly one-sixth of death is accounted for cancer among CAD patients within a median follow-up of 4.8 years. Lung, liver, and colorectum cancer are top three cancer-specific mortality. Further studies are needed to reduce cancer mortality for CAD patients, especially in older and male ones.
TRAIL REGISTRATION
(ClinicalTrials.gov NCT05050877).
背景
在全球范围内，冠心病 (CAD) 和癌症是导致死亡的主要原因。目前缺乏针对 CAD 患者癌症死亡率比例和范围的研究。本研究旨在分析 CAD 患者癌症特异性死亡率的比例和范围。
方法
我们分析了 2007 年至 2020 年间接受血管造影确诊 CAD 并住院治疗的 93797 例幸存者（平均年龄 62.8±11.1 岁，24.7%为女性），这些患者均来自 Cardiorenal ImprovemeNt II（CIN-II）队列。
结果
在中位随访 4.8 年（IQR：2.6-7.5）期间，13162 例（14.0%的全因死亡）患者出院后死亡。共有 7703 例 CAD 患者（癌症死亡原因的 15.8%）死于癌症。癌症特异性死亡的三种最常见类型是肺癌（36.1%）、肝癌（13.3%）和结直肠癌（12.8%）。此外，男性（调整后 HR 2.38，95%CI：1.99-2.85）和年龄较大（≥60 岁 vs. <60 岁，调整后 HR 3.25，95%CI 2.72-3.88）的患者癌症特异性死亡率显著增加。
结论
我们的数据表明，在中位随访 4.8 年期间，近六分之一的 CAD 患者的死亡归因于癌症。肺癌、肝癌和结直肠癌是癌症特异性死亡的前三种原因。需要进一步研究以降低 CAD 患者的癌症死亡率，尤其是年龄较大和男性患者。
试验注册
（ClinicalTrials.gov NCT05050877）。
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