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[消化道癌症与冠状动脉疾病严重程度之间的关联]

[Association between digestive tract cancer and severity of coronary artery disease].

作者信息

Zhu S N, Sun M Z, Wang Y H, Sun Z J, Chen Y D, Hu S Y

机构信息

Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Nov 14;103(42):3410-3415. doi: 10.3760/cma.j.cn112137-20230906-00399.

Abstract

To evaluate the association between digestive tract cancer and anatomical severity of coronary artery disease. This study enrolled 142 patients with digestive tract cancer who underwent coronary angiography in the Department of Cardiology of the First Medical Center of Chinese PLA General Hospital from 2009 to 2020 as the cancer group. The patients in cancer group were matched with 426 non-cancer patients who underwent coronary angiography at our hospital during the same period in a 1∶3 ratio based on gender and age. All enrolled patients had no previous history of percutaneous coronary intervention or coronary artery bypass grafting surgery. The severity of coronary artery disease was documented and assessed using the SYNTAX score based on angiogram. High SYNTAX score (SXhigh) was defined as SYNTAX score≥22 (upper quartile), while low SYNTAX score (SXlow) was SYNTAX score<22. High NLR (NLRhigh) was NLR≥2.287 (median), while low NLR (NLRlow) was NLR<2.287. The association between digestive tract cancer and severity of coronary artery disease was analyzed using logistic regression analysis. This study included a total of 568 patients, with a mean age of (66.6±8.7) years. Among them, 430 patients (75.7%) were male. The cancer group consisted of 142 patients with digestive tract cancers, with a mean age of (66.5±8.4) years. The non-cancer group consisted of 426 patients, with a mean age of (66.7±8.8) years. The proportion of SXhigh in patients with digestive tract cancers (33.1%, 47 patients) was higher than that in non-cancer patients (23.9%, 102 patients) (=0.032). Compared to non-cancer patients, SXhigh in patients with digestive tract cancers was higher (: 1.614, 95%: 1.051-2.481, =0.029). Subgroup analysis stratified by NLR levels revealed that in the NLRhigh group, patients with digestive tract cancers exhibited a higher severity of coronary artery disease compared to non-cancer patients, with an of 1.948 (95%: 1.005-3.779, =0.048). In the NLRlow group, there was no significant relationship between digestive tract cancers and the severity of coronary artery disease, with an of 1.277 (95%: 0.586-2.781, =0.538). Digestive tract cancer is associated with the severity of coronary artery disease, and patients with digestive tract cancers have a higher risk of severe coronary artery disease than non-cancer patients. Additionally, there is an association between digestive tract cancers and the severity of coronary artery disease under conditions of high levels of inflammation.

摘要

评估消化道癌症与冠状动脉疾病解剖学严重程度之间的关联。本研究纳入了142例2009年至2020年在中国人民解放军总医院第一医学中心心内科接受冠状动脉造影的消化道癌症患者作为癌症组。根据性别和年龄,癌症组患者与同期在我院接受冠状动脉造影的426例非癌症患者按1∶3的比例进行匹配。所有纳入患者既往均无经皮冠状动脉介入治疗或冠状动脉旁路移植手术史。基于血管造影使用SYNTAX评分记录并评估冠状动脉疾病的严重程度。高SYNTAX评分(SXhigh)定义为SYNTAX评分≥22(上四分位数),而低SYNTAX评分(SXlow)为SYNTAX评分<22。高中性粒细胞与淋巴细胞比值(NLRhigh)为NLR≥2.287(中位数),而低NLR(NLRlow)为NLR<2.287。采用逻辑回归分析消化道癌症与冠状动脉疾病严重程度之间的关联。本研究共纳入568例患者,平均年龄为(66.6±8.7)岁。其中,430例患者(75.7%)为男性。癌症组由142例消化道癌症患者组成,平均年龄为(66.5±8.4)岁。非癌症组由426例患者组成,平均年龄为(66.7±8.8)岁。消化道癌症患者中SXhigh的比例(33.1%,47例)高于非癌症患者(23.9%,102例)(P=0.032)。与非癌症患者相比,消化道癌症患者的SXhigh更高(比值比:1.614,95%置信区间:1.051-2.481,P=0.029)。按NLR水平分层的亚组分析显示,在NLRhigh组中,消化道癌症患者的冠状动脉疾病严重程度高于非癌症患者,比值比为1.948(95%置信区间:1.005-3.779,P=0.048)。在NLRlow组中,消化道癌症与冠状动脉疾病严重程度之间无显著关系,比值比为1.277(95%置信区间:0.586-2.781,P=0.538)。消化道癌症与冠状动脉疾病的严重程度相关,消化道癌症患者发生严重冠状动脉疾病的风险高于非癌症患者。此外,在炎症水平较高的情况下,消化道癌症与冠状动脉疾病的严重程度之间存在关联。

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