Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan.
Oncology. 2024;102(9):775-784. doi: 10.1159/000536449. Epub 2024 Jan 25.
We sought to examine the association of cancer history with the incidence of individual cardiovascular disease events and to clarify whether the history of cancer modifies the relationship between conventional cardiovascular risk factors and incident cardiovascular disease.
This retrospective cohort study used the JMDC Claims Database, including 3,531,683 individuals. The primary endpoint was the composite cardiovascular disease outcome, which included myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation.
During a follow-up, 144,162 composite endpoints were recorded. Individuals with a history of cancer had a higher risk of developing composite cardiovascular disease events (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.22-1.29). The HRs for myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation were 1.11 (95% CI 0.98-1.27), 1.15 (95% CI 1.10-1.20), 1.11 (95% CI 1.05-1.18), 1.39 (95% CI 1.34-1.44), and 1.22 (95% CI 1.13-1.32), respectively. Individuals who required chemotherapy for cancer had a higher risk of developing cardiovascular disease. Although conventional risk factors (e.g., overweight/obesity, hypertension, and diabetes) were associated with incident composite cardiovascular disease even in individuals with a history of cancer, the total population-attributable fractions of conventional risk factors were less in individuals with a history of cancer.
Individuals with a history of cancer (particularly those requiring chemotherapy) have a higher risk of cardiovascular disease. Traditional risk factors are important in the development of cardiovascular disease in individuals with and without a history of cancer. In individuals with a history of cancer, however, the total population-attributable fractions of conventional risk factors decreased.
本研究旨在探讨癌症史与心血管疾病事件发生的相关性，并阐明癌症史是否改变了传统心血管危险因素与心血管疾病发病之间的关系。
本回顾性队列研究使用了 JMDC 理赔数据库，纳入了 3531683 名个体。主要终点为复合心血管疾病结局，包括心肌梗死、心绞痛、卒 中、心力衰竭和心房颤动。
在随访期间，共记录到 144162 例复合终点事件。有癌症史的个体发生复合心血管疾病事件的风险更高（风险比[HR] 1.26，95%置信区间[CI] 1.22-1.29）。心肌梗死、心绞痛、卒 中、心力衰竭和心房颤动的 HR 分别为 1.11（95%CI 0.98-1.27）、1.15（95%CI 1.10-1.20）、1.11（95%CI 1.05-1.18）、1.39（95%CI 1.34-1.44）和 1.22（95%CI 1.13-1.32）。因癌症接受化疗的个体发生心血管疾病的风险更高。尽管传统危险因素（如超重/肥胖、高血压和糖尿病）在有癌症史的个体中与复合心血管疾病的发生相关，但在有癌症史的个体中，传统危险因素的总人群归因分数较低。
有癌症史（尤其是需要化疗的个体）的个体发生心血管疾病的风险更高。传统危险因素在有和无癌症史的个体发生心血管疾病中都很重要。然而，在有癌症史的个体中，传统危险因素的总人群归因分数降低。
