引言我们试图研究癌症病史与个体心血管疾病事件发生率之间的关系,并阐明癌症病史是否改变了传统心血管危险因素与心血管疾病发生率之间的关系。方法本回顾性队列研究使用JMDC索赔数据库,包括3,531,683人。主要终点是复合心血管疾病结局,其中包括心肌梗塞,心绞痛,中风,心力衰竭,和心房颤动。结果在随访期间,记录了144,162个复合终点。有癌症病史的个体发生复合心血管疾病事件的风险较高(HR1.26,95%CI1.22-1.29)。心肌梗死的HR,心绞痛,中风,心力衰竭,房颤为1.11(95%CI0.98-1.27),1.15(95%CI1.10-1.20),1.11(95%CI1.05-1.18),1.39(95%CI1.34-1.44),和1.22(95%CI1.13-1.32),分别。需要化疗治疗癌症的人患心血管疾病的风险更高。尽管常规风险因素(例如,超重/肥胖,高血压,和糖尿病)即使在有癌症病史的个体中也与复合心血管疾病有关,在有癌症病史的个体中,常规危险因素的总人群归因分数较低.结论有癌症病史的人(特别是需要化疗的人)患心血管疾病的风险较高。传统的危险因素在有和没有癌症史的个体的心血管疾病的发展中很重要。在有癌症史的个体中,然而,常规危险因素的总人群归因分数下降.
BACKGROUND: We sought to examine the association of cancer history with the incidence of individual cardiovascular disease events and to clarify whether the history of cancer modifies the relationship between conventional cardiovascular risk factors and incident cardiovascular disease.
METHODS: This retrospective cohort study used the JMDC Claims Database, including 3,531,683 individuals. The primary endpoint was the composite cardiovascular disease outcome, which included myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation.
RESULTS: During a follow-up, 144,162 composite endpoints were recorded. Individuals with a history of cancer had a higher risk of developing composite cardiovascular disease events (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.22-1.29). The HRs for myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation were 1.11 (95% CI 0.98-1.27), 1.15 (95% CI 1.10-1.20), 1.11 (95% CI 1.05-1.18), 1.39 (95% CI 1.34-1.44), and 1.22 (95% CI 1.13-1.32), respectively. Individuals who required chemotherapy for cancer had a higher risk of developing cardiovascular disease. Although conventional risk factors (e.g., overweight/obesity, hypertension, and diabetes) were associated with incident composite cardiovascular disease even in individuals with a history of cancer, the total population-attributable fractions of conventional risk factors were less in individuals with a history of cancer.
CONCLUSIONS: Individuals with a history of cancer (particularly those requiring chemotherapy) have a higher risk of cardiovascular disease. Traditional risk factors are important in the development of cardiovascular disease in individuals with and without a history of cancer. In individuals with a history of cancer, however, the total population-attributable fractions of conventional risk factors decreased.