Association of myocardial injury with adverse long-term survival among cancer patients

被引:2
作者
Bashar, Hussein [1 ,2 ,3 ]
Kobo, Ofer [3 ,4 ]
Curzen, Nick [1 ,2 ]
Mamas, Mamas A. [3 ]
机构
[1] Univ Southampton, Fac Med, Univ Rd, Southampton SO17 1BJ, England
[2] Univ Hosp Southampton NHS Fdn Trust, Coronary Res Grp, Tremona Rd, Southampton SO16 6YD, England
[3] Keele Univ, Inst Primary Care & Hlth Sci, Ctr Prognosis Res, Keele Cardiovasc Res Grp, Keele ST5 5BG, England
[4] Hillel Yaffe Med Ctr, Dept Cardiol, Ha Shalom St, IL-3820302 Hadera, Israel
关键词
Troponin; Cardiac biomarkers; Myocardial damage; All-cause mortality; Long-term; Myocardial injury; CARDIOVASCULAR-DISEASE; TROPONIN-I; RISK STRATIFICATION; BREAST-CANCER; BIOMARKERS; ATHEROSCLEROSIS; CARDIOTOXICITY; PREVENTION;
D O I
10.1093/eurjpc/zwae116
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Over time, cardiovascular disease (CVD) deaths increasingly exceed those from malignancy among cancer survivors. However, the association of myocardial injury with long-term survival (beyond 3 years) in cancer patients has not been previously described. Methods and results The high-sensitivity cardiac troponin (hs-cTn) and morbidities databases from the National Health and Nutrition Examination Survey (1999-2004) were linked with the latest mortality dataset isolating records were respondents reported cancer diagnosis by a healthcare professional. Myocardial injury was then determined by elevated hs-cTn. A total of 16 225 560 weighted records (1058 unweighted) were included in this observational study, with myocardial injury identified in 14.2%. Those with myocardial injury had progressively worse survival at 5 (51.6 vs. 89.5%), 10 (28.3 vs. 76.0%), and 15 years (12.6 vs. 61.4%) compared with those without myocardial injury. After adjusting for baseline characteristics, those with myocardial injury had an adjusted hazard ratio (aHR) of 2.10 [95% confidence interval (CI) 2.09-2.10, P < 0.001] for all-cause mortality, 2.23 (2.22-2.24, P < 0.001) for cardiovascular mortality, and 1.59 (95% CI 1.59-1.60, P < 0.001) for cancer mortality compared with those without myocardial injury. Among patients with no pre-existing CVD, the hs-cTn I Ortho assay was a strong independent predictor of all-cause (aHR 6.29, 95% CI 6.25-6.33, P < 0.001), CVD (aHR 11.38, 95% CI 11.23-11.54, P < 0.001), and cancer (aHR 5.02, 95% CI 4.96-5.07, P < 0.001) mortalities. Conclusion As a marker for myocardial injury, hs-cTns were independently associated with worse long-term survival among cancer patients with a stronger relationship with all-cause, cardiovascular, and cancer mortalities using hs-cTn I Ortho assay. {GRAPHIACAL ABSTRACT}
引用
收藏
页数:9
相关论文
共 33 条
  • [31] Nutrition, metabolism, and the complex pathophysiology of cachexia in chronic heart failure
    von Haehling, Stephan
    Doehner, Wolfram
    Anker, Stefan D.
    [J]. CARDIOVASCULAR RESEARCH, 2007, 73 (02) : 298 - 309
  • [32] 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines
    Zamorano, Jose Luis
    Lancellotti, Patrizio
    Munoz, Daniel Rodriguez
    Aboyans, Victor
    Asteggiano, Riccardo
    Galderisi, Maurizio
    Habib, Gilbert
    Lenihan, Daniel J.
    Lip, Gregory Y. H.
    Lyon, Alexander R.
    Lopez Fernandez, Teresa
    Mohty, Dania
    Piepoli, Massimo F.
    Tamargo, Juan
    Torbicki, Adam
    Suter, Thomas M.
    Zamorano, Jose Luis
    Aboyans, Victor
    Achenbach, Stephan
    Agewall, Stefan
    Badimon, Lina
    Baron-Esquivias, Gonzalo
    Baumgartner, Helmut
    Bax, Jeroen J.
    Bueno, Hector
    Carerj, Scipione
    Dean, Veronica
    Erol, Cetin
    Fitzsimons, Donna
    Gaemperli, Oliver
    Kirchhof, Paulus
    Kolh, Philippe
    Lancellotti, Patrizio
    Lip, Gregory Y. H.
    Nihoyannopoulos, Petros
    Piepoli, Massimo F.
    Ponikowski, Piotr
    Roffi, Marco
    Torbicki, Adam
    Carneiro, Antonio Vaz
    Windecker, Stephan
    Achenbach, Stephan
    Minotti, Giorgio
    Agewall, Stefan
    Badimon, Lina
    Bueno, Hector
    Cardinale, Daniela
    Carerj, Scipione
    Curigliano, Giuseppe
    de Azambuja, Evandro
    [J]. EUROPEAN HEART JOURNAL, 2016, 37 (36) : 2768 - 2801
  • [33] The association of preoperative high-sensitivity cardiac troponin i and long-term outcomes in colorectal cancer patients received tumor resection surgery
    Zhang, Yitao
    Huang, Zicheng
    Hu, Sutian
    Si, Jinhong
    Cheng, Shiyao
    Chen, Zhichong
    Xue, Jiaojie
    Lou, Xue
    Peng, Huajing
    Li, Zequan
    Ouyang, Mao
    Gao, Xiang
    Zeng, Weijie
    [J]. CARDIO-ONCOLOGY, 2023, 9 (01)