JACC:严重主动脉瓣狭窄的肿瘤患者进行的经导管主动脉瓣置换术

2019-01-09 xiangting MedSci原创

与无癌症患者相比,癌症患者的TAVR与相似的短期预后和较差的长期预后相关。

这项研究旨在收集有关严重主动脉瓣狭窄(AS)的肿瘤患者接受经导管主动脉瓣置换术(TAVR)当代实践和结局的数据。

伴严重AS的肿瘤患者常被拒绝进行瓣膜置换。TAVR可能是这类患者一种新兴的治疗选择。

研究人员设计了一项全球性登记旨在收集在活动性恶性肿瘤期间接受TAVR的患者数据。将来自18个TAVR中心222名癌症患者的数据与来自5个参与中心2,522名"无癌症"患者进行了比较。进行倾向得分匹配以进一步调整偏倚。

癌症患者年龄为78.8±7.5岁,STS评分为4.9±3.4%,男性占62%。最常见的癌症是胃肠道癌症(22%)、前列腺癌(16%)、乳腺癌(15%)、血液系统肿瘤(15%)和肺癌(11%)。在TAVR时,40%的患者为4期癌症。组间的围手术期并发症相当。尽管30天死亡率相似,但癌症患者的1年死亡率更高(15%vs. 9%; p<0.001); 一半的死亡是由肿瘤引起的。TAVR后1年仍存活的患者中,三分之一癌症缓解/治愈。进展性恶性肿瘤(III期至IV期)是强有力的死亡率预测因子(风险比:2.37; 95%置信区间:1.74至3.23; p<0.001),而与无癌症患者相比,I至II期癌症与较高的死亡率无关。

与无癌症患者相比,癌症患者的TAVR与相似的短期预后和较差的长期预后相关。在这个队列中,死亡率主要是由癌症引起的,而进展性恶性肿瘤是一种强有力的死亡率预测因子。重要的是,85%的患者在1年时仍存活,三分之一的患者癌症缓解/治愈。(严重主动脉瓣狭窄的肿瘤患者接受经导管主动脉瓣植入术的结局[TOP-AS];NCT03181997)

原始出处:

Uri Landes. Transcatheter Aortic Valve Replacement in Oncology Patients With Severe Aortic Stenosis. JACC:Cardiovascular Interventions. 14 January 2019.

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    2019-05-09 hbwxf
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    2019-06-19 yxch48
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    2019-01-11 hb2008ye
  5. 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  6. 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  7. 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    2019-01-11 lsj631
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