Kuwabara Yoshihiro, Morishima Toshitaka, Kudo Haruka, Ma Chaochen, Kato Mizuki Shimadzu, Koyama Shihoko, Nakata Kayo, Tabuchi Takahiro, Miyashiro Isao
Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Heliyon. 2024 Feb 5;10(3):e25594. doi: 10.1016/j.heliyon.2024.e25594. eCollection 2024 Feb 15.
The incidence of malignancy and cardiovascular disease (CVD) is increasing worldwide. However, it is not entirely clear how the coexistence of CVD at the time of cancer diagnosis affects the overall survival of patients with cancer.
We used the cancer registries and administrative claims data of patients diagnosed with cancer at 36 designated cancer care hospitals in Osaka, Japan, from 2010 to 2015. The Cox proportional hazard model was used to examine how coexisting CVD (heart failure [HF], ischemic heart disease, peripheral arterial disease, cerebrovascular accidents, and atrial fibrillation) affected overall survival and the impact of HF severity, as documented by the New York Heart Association (NYHA) classification. Of the 131,701 patients with cancer, 9704 had coexisting CVD. The 3-year survival rates for patients with and without coexisting CVD were 62.9 % and 77.6 %, respectively. The adjusted hazard ratio (aHR) for all-cause mortality for coexisting CVD was 1.47 (95 % confidence interval, 1.41-1.52). Among the CVD subtype, patients with coexisting HF had the poorest prognosis. The aHRs in patients with HF by NYHA classification, using the patients without HF as a reference, were as follows: Class I: 1.33 (p = 0.217); II: 1.68 (p < 0.001); III: 1.54 (p = 0.011); IV: 2.47 (p < 0.001).
Coexisting CVD and HF severity at cancer diagnosis is associated with survival in patients with cancer.
全球范围内，恶性肿瘤和心血管疾病（CVD）的发病率正在上升。然而，癌症诊断时CVD的共存如何影响癌症患者的总生存期，目前尚不完全清楚。
我们使用了2010年至2015年期间在日本大阪36家指定癌症护理医院被诊断为癌症的患者的癌症登记和行政索赔数据。采用Cox比例风险模型来研究共存的CVD（心力衰竭[HF]、缺血性心脏病、外周动脉疾病、脑血管意外和心房颤动）如何影响总生存期，以及纽约心脏协会（NYHA）分类记录的HF严重程度的影响。在131,701例癌症患者中，9704例共存CVD。共存CVD和不共存CVD患者的3年生存率分别为62.9%和77.6%。共存CVD全因死亡率的调整后风险比（aHR）为1.47（95%置信区间，1.41 - 1.52）。在CVD亚型中，共存HF的患者预后最差。以无HF患者为参照，NYHA分级的HF患者的aHR如下：I级：1.33（p = 0.217）；II级：1.68（p < 0.001）；III级：1.54（p = 0.011）；IV级：2.47（p < 0.001）。
癌症诊断时共存的CVD和HF严重程度与癌症患者的生存相关。
