PDF(Pubmed)
Abstract：
Objectives: Evidence on cardiovascular-related and all-cause mortality risks in a wide range of cancer survivors is scarce but needed to inform prevention and management. Methods: We performed a nationwide prospective cohort study using information from the Continuous National Health and Nutrition Examination Survey (NHANES) in the United States and the linked mortality follow-up files, available for public access. A propensity score-matched analysis with a 1:1 ratio was conducted to reduce the baseline differences between participants with and without cancer. The relationship between cancer status and the cardiovascular-related and all-cause mortality risk was examined using weighted Cox proportional hazards regression. Independent stratification analysis and cancer-specific analyses were also performed. Results: The study sample included 44,342 participants, aged 20-85, interviewed between 1999 and 2018. Of these, 4,149 participants had cancer. All-cause death occurred in 6,655 participants, of whom 2,053 died from cardiovascular causes. Propensity-score matching identified 4,149 matched pairs of patients. A fully adjusted Cox proportional hazards regression showed that cancer was linked to an elevated risk of cardiovascular-related and all-cause mortality both before and after propensity score matching. Stratification analysis and cancer-specific analyses confirmed robustness of results. Conclusion: Our study confirmed that cancer was strongly linked to cardiovascular-related and all-cause mortality, even after adjusting for other factors that could impact a risk, including the American Heart Association (AHA)\'s Life\'s Simple 7 cardiovascular health score, age, sex, ethnicity, marital status, income, and education level.
摘要：
目标：广泛的癌症幸存者中心血管相关和全因死亡风险的证据很少，但需要为预防和管理提供信息。方法：我们使用来自美国连续国家健康和营养调查（NHANES）和相关死亡率随访文件的信息进行了全国性的前瞻性队列研究。可供公共访问。进行1：1比例的倾向评分匹配分析，以减少有和没有癌症的参与者之间的基线差异。使用加权Cox比例风险回归检查癌症状态与心血管相关和全因死亡风险之间的关系。还进行了独立分层分析和癌症特异性分析。结果：研究样本包括44,342名参与者，年龄20-85岁，1999年至2018年期间接受采访。其中,4149名参与者患有癌症。全因死亡发生在6,655名参与者中，其中2053人死于心血管疾病。倾向评分匹配确定了4,149对匹配的患者。完全校正的Cox比例风险回归表明，在倾向评分匹配之前和之后，癌症与心血管相关和全因死亡率的风险升高有关。分层分析和癌症特异性分析证实了结果的稳健性。结论：我们的研究证实癌症与心血管相关和全因死亡率密切相关。即使在调整了可能影响风险的其他因素之后，包括美国心脏协会（AHA）的生活简单7心血管健康评分，年龄,性别,种族,婚姻状况,收入,和教育水平。
