Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark.
Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark; Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
Int J Cardiol. 2024 Jul 1;406:132001. doi: 10.1016/j.ijcard.2024.132001. Epub 2024 Mar 30.
Pulmonary embolism (PE) is described as a prognostic factor in patients with cancer however, the prognostic impact of PE remains unknown. This study investigated, the 1-year prognosis following PE in patients with breast-, gastrointestinal-, or lung cancer stratified by cancer status.
All Danish patients with first-time PE from 2008 to 2018 were included. Cancer status was categorized as no cancer, history of cancer, non-active cancer and active cancer. Unadjusted and age-stratified 1-year risk of death was estimated using the Kaplan-Meier estimator. Cause of death was reported using the Aalen-Johansen method.
Of 35,679 patients with PE, 18% had a breast-, gastrointestinal-, or lung cancer. Patients with cancer were older compared with no cancer (69.8 years [IQR: 56.2-79.8]). One-year risk of death (95% confidence interval) for active breast-, gastrointestinal-, and lung cancer was 49.5% (44.0%-54.9%), 75.0% (72.5%-77.4%) and 80.1% (78.0%-82.3%) respectively, compared with 18.9% (18.4%-19.3%) for no cancer. Age-stratified analysis revealed no association with increasing age in non-active lung cancer and all active cancers. Further, non-cardiovascular death accounted for an increasing proportion by cancer status (no cancer < history of cancer < non-active cancer < active cancer).
One-year risk of death was dependent on both cancer type and status; no association with age was found for patients with active cancers. Non-cardiovascular death was leading in non-active and active cancers. Thus, the occurrence of first-time PE could be regarded as a marker of cancer severity for patients with breast-, gastrointestinal-, and lung cancer.
肺栓塞 (PE) 被描述为癌症患者的预后因素，但 PE 的预后影响尚不清楚。本研究调查了 2008 年至 2018 年间首次发生 PE 的乳腺癌、胃肠道癌或肺癌患者的 PE 后 1 年预后，按癌症状态进行分层。
纳入所有丹麦首次发生 PE 的患者。癌症状态分为无癌症、有癌症史、非活动性癌症和活动性癌症。使用 Kaplan-Meier 估计器估计未经调整和按年龄分层的 1 年死亡风险。使用 Aalen-Johansen 方法报告死亡原因。
在 35679 例 PE 患者中，18%患有乳腺癌、胃肠道癌或肺癌。与无癌症患者相比，癌症患者年龄更大（69.8 岁 [IQR：56.2-79.8]）。活动性乳腺癌、胃肠道癌和肺癌的 1 年死亡风险（95%置信区间）分别为 49.5%（44.0%-54.9%）、75.0%（72.5%-77.4%）和 80.1%（78.0%-82.3%），而无癌症患者为 18.9%（18.4%-19.3%）。分层分析显示，非活动性肺癌和所有活动性癌症与年龄增加无关。此外，非心血管死亡在不同癌症状态下的比例呈上升趋势（无癌症<有癌症史<非活动性癌症<活动性癌症）。
1 年死亡风险取决于癌症类型和状态；活动性癌症患者与年龄无关联。非心血管死亡在非活动性和活动性癌症中占主导地位。因此，首次发生 PE 可被视为乳腺癌、胃肠道癌和肺癌患者癌症严重程度的标志物。
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