Jung Mi-Hyang, Jung Moon-Kyung, Kim Eui-Soon, Youn Jong-Chan, Lee Eun Young, Kang Dongwoo, Kyoung Dae-Sung, Chung Woo-Baek, Jung Hae Ok, Ihm Sang-Hyun, Lee Hokyou, Ng Choon Ta, Kim Hyeon Chang
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cancers (Basel). 2025 Mar 26;17(7):1117. doi: 10.3390/cancers17071117.
BACKGROUND/OBJECTIVES: Cancer survivors increasingly face cardiovascular disease (CVD), with diabetes as a major risk factor. This study investigates the relationship between adherence to antidiabetic medications and cardiovascular (CV) outcomes in cancer patients.
Using data from the Korean National Health Insurance Service-National Sample Cohort, we assessed the clinical outcomes of adult cancer patients prescribed antidiabetic medications. The study population was categorized based on medication adherence, as determined by the medication possession ratio (MPR): good (MPR ≥ 0.8), moderate (0.5 ≤ MPR < 0.8), and poor (MPR < 0.5) adherence. The primary outcomes included overall and CV mortality, with secondary outcomes encompassing hospitalization for major CVDs and healthcare costs.
Among the 7928 cancer patients with diabetes, 59.7% were nonadherent (22.1% with moderate and 37.6% with poor adherence). Over a median follow-up of 5.7 years, 1462 deaths and 2897 CV events were confirmed. Multivariable adjusted analyses showed a 1.70-fold and 2.11-fold higher risk of overall mortality for the moderate and poor adherence groups, respectively, compared to the good adherence group. For CV mortality, moderate adherence was associated with a 1.51-fold higher risk, and poor adherence with a 2.10-fold higher risk. The risk for new-onset CV events increased by 1.32-fold in the moderate adherence group and 1.44-fold in the poor adherence group. The good adherence group also showed significantly lower total healthcare costs compared to the nonadherence group.
The present study underscores the importance of adherence to antidiabetic medications in cancer patients, revealing significant associations with decreased mortality, CV events, and healthcare costs.
背景/目的：癌症幸存者越来越多地面临心血管疾病（CVD），糖尿病是主要危险因素。本研究调查了癌症患者抗糖尿病药物依从性与心血管（CV）结局之间的关系。
利用韩国国民健康保险服务-全国样本队列的数据，我们评估了开具抗糖尿病药物的成年癌症患者的临床结局。根据药物持有率（MPR）确定的药物依从性，将研究人群分为：依从性良好（MPR≥0.8）、中等（0.5≤MPR<0.8）和依从性差（MPR<0.5）。主要结局包括全因死亡率和心血管死亡率，次要结局包括主要心血管疾病住院率和医疗费用。
在7928例糖尿病癌症患者中，59.7%为不依从（22.1%为中等依从性，37.6%为差依从性）。在中位随访5.7年期间，确认了1462例死亡和2897例心血管事件。多变量调整分析显示，与依从性良好组相比，中等依从性组和差依从性组的全因死亡风险分别高1.70倍和2.11倍。对于心血管死亡率，中等依从性与高1.51倍的风险相关，差依从性与高2.10倍的风险相关。中等依从性组新发心血管事件风险增加1.32倍，差依从性组增加1.44倍。与不依从组相比，依从性良好组的总医疗费用也显著更低。
本研究强调了癌症患者坚持服用抗糖尿病药物的重要性，揭示了与死亡率降低、心血管事件和医疗费用之间的显著关联。
