Wang Chengshi, Wang Zhu, Yang Jing, Zhang Songbo, Zhang Purong, Yang Ye
Department of Breast Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
Institute for Breast Health Medicine, West China Hospital, Sichuan University, Chengdu, China.
Front Cardiovasc Med. 2025 Jan 6;11:1491912. doi: 10.3389/fcvm.2024.1491912. eCollection 2024.
The aim of the present study was to investigate the cardiovascular mortality risk among lung cancer patients compared to the general population.
Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, we conducted a population-based cohort study including 278,418 lung cancer patients aged over 30 years between 1 January 1990 and 31 December 2020 as well as the general population. Poisson regression was employed to calculate incidence rate ratios (IRRs) for cardiovascular mortality.
Patients exhibited a significantly higher IRR of cardiovascular mortality risk compared to the general population [IRR 1.74, 95% confidence interval (CI) 1.71-1.77]. The risk was most pronounced in patients aged 30-79 years (IRR 2.61, 95% CI 2.55-2.66), peaking at ages 30-34 years (IRR 48.93, 95% CI 21.98-108.92). Elevated cardiovascular mortality risks were observed across all subgroups, including diseases of the heart (IRR 1.79, 95% CI 1.75-1.82), cerebrovascular diseases (IRR 1.52, 95% CI 1.45-1.59), and other cardiovascular diseases (IRR 1.78, 95% CI 1.67-1.90). The first month after diagnosis presented the highest risk for patients aged 30-79 years (IRR 12.08, 95% CI 11.49-12.70) and ≥80 years (IRR 4.03, 95% CI 3.70-4.39). Clinical characteristics significantly modified cardiovascular mortality.
Integrating cardiovascular disease monitoring and proactive management into lung cancer treatment protocols is essential to the improvement of overall survival and quality of life for lung cancer patients, particularly those who were young or with advanced tumor stage.
本研究旨在调查肺癌患者相较于普通人群的心血管疾病死亡风险。
利用美国国立癌症研究所监测、流行病学和最终结果计划的数据，我们开展了一项基于人群的队列研究，纳入了1990年1月1日至2020年12月31日期间年龄超过30岁的278418例肺癌患者以及普通人群。采用泊松回归计算心血管疾病死亡率的发病率比值（IRR）。
与普通人群相比，患者的心血管疾病死亡风险IRR显著更高[IRR 1.74，95%置信区间（CI）1.71 - 1.77]。该风险在30 - 79岁患者中最为明显（IRR 2.61，95% CI 2.55 - 2.66），在30 - 34岁时达到峰值（IRR 48.93，95% CI 21.98 - 108.92）。在所有亚组中均观察到心血管疾病死亡风险升高，包括心脏疾病（IRR 1.79，95% CI 1.75 - 1.82）、脑血管疾病（IRR 1.52，95% CI 1.45 - 1.59）以及其他心血管疾病（IRR 1.78，95% CI 1.67 - 1.90）。诊断后的第一个月，30 - 79岁患者（IRR 12.08，95% CI 11.49 - 12.70）和≥80岁患者（IRR 4.03，95% CI 3.70 - 4.39）的风险最高。临床特征显著改变了心血管疾病死亡率。
将心血管疾病监测和积极管理纳入肺癌治疗方案对于提高肺癌患者的总体生存率和生活质量至关重要，尤其是对于年轻患者或肿瘤分期较晚的患者。
