Department of Family Medicine/Executive Healthcare Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, The Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Gastric Cancer. 2024 Nov;27(6):1169-1179. doi: 10.1007/s10120-024-01540-3. Epub 2024 Jul 30.
Previous studies have investigated cardiovascular disease (CVD) risks in cancer patients, but there is limited knowledge concerning the CVD risk in adult and young adolescent (AYA) survivors of gastric cancer.
This study aims to investigate the incidence of CVD in AYA gastric cancer survivors, analyzing it by treatment type and identifying associated risk factors.
We conducted a retrospective cohort study using Korean National Health Insurance Service data collected from 2006 to 2019. Propensity score matching (1:3, caliper < 0.1) was performed using the variables age, sex, income, residential area, and presence of comorbidities, and we classified participants into gastric cancer (n = 6562) and non-cancer control (n = 19,678) groups. Cox regression models were used to calculate hazard ratios (HRs) for CVD incidence. The study assessed CVD incidence by cancer treatment and identified risk factors through multivariable Cox regression.
During a median 6.5-year follow-up, AYA gastric cancer survivors consistently exhibited greater CVD incidence. Their risk of CVD was significantly elevated compared to that of controls (HR, 1.18; 95% confidence interval [CI] 1.05-1.33). In particular, deep vein thrombosis (HR, 3.93; 95% CI 3.06-14.67) and pulmonary embolism (HR, 6.58; 95% CI 3.06-14.67) risks were notably increased. Chemotherapy was associated with an increased risk of stroke, heart failure, atrial fibrillation, deep vein thrombosis, and pulmonary embolism. Hypertension (HR, 1.58; 95% CI 1.10-2.26) and dyslipidemia (HR, 1.46; 95% CI 1.06-2.20) emerged as risk factors for CVD development.
This study reports elevated risks of CVD in AYA gastric cancer survivors and emphasizes the need for vigilant monitoring of CVD in this population.
先前的研究已经调查了癌症患者的心血管疾病（CVD）风险，但对于胃癌成年和青少年（AYA）幸存者的 CVD 风险知之甚少。
本研究旨在调查 AYA 胃癌幸存者的 CVD 发生率，通过治疗类型进行分析，并确定相关的危险因素。
我们使用 2006 年至 2019 年期间收集的韩国国家健康保险服务数据进行了回顾性队列研究。使用年龄、性别、收入、居住地区和合并症存在情况等变量进行倾向评分匹配（1:3，卡尺<0.1），并将参与者分为胃癌（n=6562）和非癌症对照组（n=19678）。使用 Cox 回归模型计算 CVD 发生率的风险比（HR）。该研究通过癌症治疗评估 CVD 发生率，并通过多变量 Cox 回归确定危险因素。
在中位数为 6.5 年的随访期间，AYA 胃癌幸存者的 CVD 发生率持续升高。与对照组相比，他们的 CVD 风险显著增加（HR，1.18；95%置信区间 [CI] 1.05-1.33）。特别是深静脉血栓形成（HR，3.93；95% CI 3.06-14.67）和肺栓塞（HR，6.58；95% CI 3.06-14.67）的风险明显增加。化疗与中风、心力衰竭、心房颤动、深静脉血栓形成和肺栓塞的风险增加相关。高血压（HR，1.58；95% CI 1.10-2.26）和血脂异常（HR，1.46；95% CI 1.06-2.20）是 CVD 发生的危险因素。
本研究报告了 AYA 胃癌幸存者 CVD 风险升高，并强调需要对此人群进行 CVD 的密切监测。
