Int J Cardiol:慢性心力衰竭患者癌症死亡风险增加

2019-04-29 xing.T 网络

由此可见,这些结果提供了HF与癌症死亡增加相关的第一个证据,特别是当与长期炎症相关时。

虽然已知的包括心力衰竭(HF)和炎症在内的几个因素会增加癌症的发病率,但是HF是否会增加癌症死亡率仍然是未知的,特别是在涉及炎症方面。

近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,在CHART-2研究中研究人员评估了8843名没有癌症病史的连续就诊的血管病患者(平均年龄为68岁,女性占30.9%)。与没有HF的患者(A/B期,N=4622)相比,HF(C/D期,N=4221)患者的特征是糖尿病、既往心肌梗塞、心房颤动和卒中的患病率更高。

在中位数为6.5年的随访期间(52675人/年),发生了282例癌症患者死亡。HF患者的总体(3.7 vs. 2.8%,风险比(HR)为1.42,95%置信区间(CI)为1.12-1.79,P=0.004)和倾向得分匹配队列(HR为1.46,95%CI为1.10-1.93,P=0.008)癌症死亡率显著高于无HF患者,这在竞争风险模型中得到证实。匹配队列中的多变量Cox比例风险模型显示HF与基线C反应蛋白(CRP)≥2.0mg/ L(HR为1.87,95%CI为1.18-2.96,P=0.008)患者的癌症死亡率增加有关。但在CRP<2.0mg/L的患者则无(HR为0.89,95%CI为0.54-1.45,P=0.64)(相互作用P=0.03)。此外,CRP水平的时间变化与整个队列中的癌症死亡相关;基线和1年CRP≥2.0mg/L的HF患者癌症死亡率显著增加,而基线CRP≥2.0mg/ L,1年CRP≥2.0mg/ L的HF患者则无。

由此可见,这些结果提供了HF与癌症死亡增加相关的第一个证据,特别是当与长期炎症相关时。

原始出处:

TakuyaOikawa,et al.Increased risk of cancer death in patients with chronic heart failure with a special reference to inflammation-A report from the CHART-2 Study.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.04.078

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