动脉粥样硬化性心血管疾病与转移性和非转移性癌症相关

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology Pub Date : 2024-12-01 DOI:10.1016/j.jaccao.2024.07.020

Tal Caller MSc , Alexander Fardman MD , Yariv Gerber PhD , Yonatan Moshkovits BSc , Shmuel Tiosano MD , Alon Kaplan BSc , Maia Kalstein BSc , Gabriella Bayshtok BSc , Tomer Itkin PhD , Abraham Avigdor MD , Nili Naftali-Shani PhD , Jonathan Leor MD , Elad Maor MD, PhD

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引用次数: 0

摘要

背景：心血管疾病与较高的癌症风险相关。然而，它们与转移性癌症（癌症预后的主要决定因素）的关系尚未得到研究。目的：本研究旨在确定动脉粥样硬化性心血管疾病与癌症诊断时是否存在转移之间的关系。方法：我们分析了21,654名自我推荐的成年人的数据，这些成年人在参加预防保健计划时没有癌症和动脉粥样硬化性心血管疾病。为了排除无症状的癌症，在随访开始时实施了1年的空白期。使用病因特异性Cox回归评估动脉粥样硬化性心血管疾病与转移性癌症之间的关系，将动脉粥样硬化性心血管疾病事件作为时间依赖的协变量。相互作用分析进一步阐明了中年人（Q1-Q3年龄≤54岁）和老年人（Q4年龄bb0 - 54岁）之间转移风险的差异。结果：在中位随访6年（Q1-Q3: 3-12年）期间，我们记录了1333例动脉粥样硬化性心血管疾病（6.2%）和1793例癌症（8.3%），其中1036例（4.8%）为非转移性，757例（3.5%）为诊断时转移性。在调整了共同的危险因素后，动脉粥样硬化性心血管疾病与癌症诊断时癌症转移风险增加独立相关(HR: 1.75；95% ci: 1.33-2.29)。这种关联在中年人中更为明显(HR: 1.64；95% ci: 1.03-2.61；P = 0.036)高于老年人(HR: 1.11；95% ci: 0.78-1.60；P = 0.56)，交互作用显著（P交互作用= 0.039）。结论：动脉粥样硬化性心血管疾病与癌症风险显著增加相关，特别是在癌症诊断时转移，特别是在中年人中。认识到这种关联可以加强对动脉粥样硬化性心血管疾病患者转移性癌症的预防和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Atherosclerotic Cardiovascular Diseases Are Associated With Incident Metastatic and Nonmetastatic Cancer

Background

Cardiovascular diseases are associated with higher cancer risk. However, their relationship with metastatic cancer, the primary determinant of cancer prognosis, has not been studied.

Objectives

This study aimed to determine the association between atherosclerotic cardiovascular disease and the presence of metastasis at the time of cancer diagnosis.

Methods

We analyzed data from 21,654 self-referred adults who were free of cancer and atherosclerotic cardiovascular disease at enrollment in a preventive health care program. To exclude silent cancers, a 1-year blanking period was implemented at the start of the follow-up. The relationship between atherosclerotic cardiovascular disease and metastatic cancer was assessed using cause-specific Cox regression, treating incident atherosclerotic cardiovascular disease as a time-dependent covariate. Interaction analysis further elucidated differences in metastasis risks between middle-aged adults (Q1-Q3 age ≤54 years) and older adults (Q4 age >54 years).

Results

Over a median follow-up of 6 years (Q1-Q3: 3-12 years), we recorded 1,333 cases of atherosclerotic cardiovascular disease (6.2%) and 1,793 cases of cancer (8.3%), of which 1,036 (4.8 %) were nonmetastatic and 757 (3.5%) were metastatic at diagnosis. After adjusting for shared risk factors, atherosclerotic cardiovascular disease was independently associated with an increased risk of cancer metastasis at the time of cancer diagnosis (HR: 1.75; 95% CI: 1.33-2.29). This association was more pronounced among middle-aged adults (HR: 1.64; 95% CI: 1.03-2.61; P = 0.036) than in older adults (HR: 1.11; 95% CI: 0.78-1.60; P = 0.56), with a significant interaction (P_interaction = 0.039).

Conclusions

Atherosclerotic cardiovascular disease is associated with a significantly increased risk of cancer, specifically metastasis at the time of cancer diagnosis, particularly in middle-aged adults. Recognizing this association could enhance the prevention and treatment of metastatic cancer in patients with atherosclerotic cardiovascular disease.

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来源期刊

Jacc: Cardiooncology Multiple-

CiteScore

12.50

自引率

6.30%

发文量

106

期刊介绍： JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge. The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention. Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.