■已经研究了血清生物标志物作为癌症相关心血管(CV)风险的预测风险因素,但他们的分析仅限于他们的基线水平,而不是他们的加班变化。除了历史验证的因果因素,炎症和氧化应激(OS)相关标志物似乎与CV事件相关,但这种关联需要进一步探讨.我们进行了一项观察性研究,以确定癌症治疗期间常用和OS相关生物标志物的纵向变化的预测作用。
■接受抗癌治疗的患者,根据欧洲心脏病学会指南,年龄在75岁以上或以下,心血管风险增加,已注册。我们使用Cox模型评估了基线和治疗期间生物标志物对CV事件发作的预测价值。亚群治疗效果模式图(STEPP)方法和纵向数据的重复测量分析。
■从2018年4月到2021年8月,共登记了182名受试者,其中168人是可评估的。中位随访9.2个月后记录了28个CV事件(四分位距,IQR:5.1-14.7)。纤维蛋白原和肌钙蛋白水平是CV事件的独立危险因素。具体来说,与基线时纤维蛋白原和肌钙蛋白水平低于中位数的患者相比,基线时纤维蛋白原和肌钙蛋白水平高于中位数的患者具有更高的风险,风险比(HR)=3.95,95%CI,1.25-12.45,HR=2.48,0.67-9.25。应用于Cox模型的STEPP分析显示,随着纤维蛋白原中位数的增加,18个月和24个月的累积无事件生存期几乎线性恶化。重复测量分析显示D-二聚体随时间增加(p-相互作用事件*时间=0.08),收缩压(p=0.07)和舒张压(p=0.05)以及左心室射血分数下降(p=0.15)。
基线时纤维蛋白原和肌钙蛋白水平较高以及D-二聚体和血压随时间增加与接受抗癌治疗的患者发生CV事件的风险较高相关。应进一步评估OS在纤维蛋白原增加中的作用以及D-二聚体和血压水平的纵向监测。
UNASSIGNED: Serum biomarkers have been investigated as predictive risk factors for cancer-related cardiovascular (CV) risk, but their analysis is limited to their baseline level rather than their overtime change. Besides historically validated causal factors, inflammatory and oxidative stress (OS) related markers seem to be correlated to CV events but this association needs to be further explored. We conducted an observational study to determine the predictive role of the longitudinal changes of commonly used and OS-related biomarkers during the cancer treatment period.
UNASSIGNED: Patients undergoing anticancer therapies, either aged 75+ years old or younger with an increased CV risk according to European Society of Cardiology guidelines, were enrolled. We assessed the predictive value of biomarkers for the onset of CV events at baseline and during therapy using Cox model, Subpopulation Treatment-Effect Pattern Plot (STEPP) method and repeated measures analysis of longitudinal data.
UNASSIGNED: From April 2018 to August 2021, 182 subjects were enrolled, of whom 168 were evaluable. Twenty-eight CV events were recorded after a median follow up of 9.2 months (Interquartile range, IQR: 5.1-14.7). Fibrinogen and troponin levels were independent risk factors for CV events. Specifically, patients with higher than the median levels of fibrinogen and troponin at baseline had higher risk compared with patients with values below the medians, hazard ratio (HR) = 3.95, 95% CI, 1.25-12.45 and HR = 2.48, 0.67-9.25, respectively. STEPP analysis applied to Cox model showed that cumulative event-free survival at 18 and 24 months worsened almost linearly as median values of fibrinogen increased. Repeated measure analysis showed an increase over time of D-Dimer (p-interaction event*time = 0.08), systolic (p = 0.07) and diastolic (p = 0.05) blood pressure and a decrease of left ventricular ejection fraction (p = 0.15) for subjects who experienced a CV event.
UNASSIGNED: Higher levels of fibrinogen and troponin at baseline and an increase over time of D-Dimer and blood pressure are associated to a higher risk of CV events in patients undergoing anticancer therapies. The role of OS in fibrinogen increase and the longitudinal monitoring of D-dimer and blood pressure levels should be further assessed.