癌症幸存者冠状动脉粥样硬化患病率增加：冠状动脉CT血管造影的回顾性匹配横断面研究。

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2025-01-09 DOI:10.1016/j.ahj.2025.01.004

Elissa A.S. Polomski MD , Julius C. Heemelaar MD, PhD , Mian E.S. de Ronde MD , Ahmed A.M. Al Jaff BSc , B.J.A. Mertens PhD , Paul R.M. van Dijkman MD, PhD , J. Wouter Jukema MD, PhD , M. Louisa Antoni MD, PhD

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引用次数: 0

摘要

背景：癌症和癌症治疗可能加速心血管疾病的发展。随着癌症幸存者预后的改善，心血管事件在该患者组中增加。然而，有癌症病史的患者冠状动脉粥样硬化的患病率是否会增加尚不清楚。本研究旨在评估不同年龄组癌症幸存者的冠状动脉粥样硬化患病率和严重程度，并与对照组进行比较。方法：本回顾性研究纳入了年龄在bb0 ~ 30岁、接受冠状动脉计算机断层血管造影（CCTA）评估稳定冠状动脉疾病的连续癌症幸存者。进行倾向评分匹配，癌症幸存者与无肿瘤病史的对照人群1:2匹配。评估两组患者是否存在冠状动脉粥样硬化。结果：研究人群包括312名癌症幸存者和624名匹配的对照组。CCTA扫描的中位年龄为59.2[50.3-67.5]岁，66.0%为女性。257例（82.4%）癌症幸存者出现冠状动脉粥样硬化，对照组患者为459例（73.6%），优势比（OR）为1.68 [95% CI: 1.19-2.36], p=0.003。主要是年龄在30-59岁之间的年轻癌症幸存者，与对照患者相比，冠状动脉粥样硬化患病率增加，OR为2.21 [95% CI: 1.40-3.49] （p=0.001）。此外，胸部放疗显示与年轻人群中动脉粥样硬化患病率增加有显著关联，OR为3.29 （[95% CI: 1.70-6.38]）。结论：在CCTA上，有癌症病史的患者与没有癌症的匹配患者相比，冠状动脉粥样硬化患病率增加。这种效果在30-59岁的年轻患者中最为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Increased prevalence of coronary atherosclerosis in cancer survivors: A retrospective matched cross-sectional study with coronary CT angiography

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Increased prevalence of coronary atherosclerosis in cancer survivors: A retrospective matched cross-sectional study with coronary CT angiography

Background

Cancer and cancer treatment may accelerate the development of cardiovascular disease. With the improved prognosis of cancer survivors, cardiovascular events are increasing in this patient group. However, it is unknown whether the prevalence of coronary atherosclerosis is increased in patients with a history of cancer. This study aims to evaluate the prevalence and severity of coronary atherosclerosis in different age groups of cancer survivors compared to matched controls.

Methods

Consecutive cancer survivors aged > 30 years who underwent evaluation for stable coronary artery disease with coronary computed tomography angiography (CCTA) were included in this retrospective study. Propensity score matching was performed and cancer survivors were matched 1:2 to a control population without oncological history. The presence of coronary atherosclerosis was assessed in both groups.

Results

The study population consisted of 312 cancer survivors and 624 matched controls. Median age at CCTA scan was 59.2 [50.3-67.5] years and 66.0% was female. Coronary atherosclerosis was observed in 257 (82.4%) cancer survivors compared to 459 (73.6%) control patients with an Odds Ratio (OR) of 1.68 [95% CI: 1.19-2.36], P = .003. Mainly younger cancer survivors aged between 30 and 59 years had an increased prevalence of coronary atherosclerosis with an OR of 2.21 [95% CI: 1.40-3.49] compared to control patients (P = .001). In addition, thoracic radiotherapy showed a significant association with increased prevalence of atherosclerosis in the younger population with an OR of 3.29 ([95% CI: 1.70-6.38], P < .001).

Conclusions

Patients with a history cancer have an increased prevalence of coronary atherosclerosis on CCTA compared to matched patients without cancer. This effect was most pronounced in younger patients aged 30 to 59 years.

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来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.