Cancer as an independent mortality risk in chronic thromboembolic pulmonary hypertension.

IF 6.4 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Heart and Lung Transplantation Pub Date : 2024-10-30 DOI:10.1016/j.healun.2024.10.022
Junichi Nakamura, Ichizo Tsujino, Kohei Masaki, Kazuya Hosokawa, Kouta Funakoshi, Yu Taniguchi, Shiro Adachi, Takumi Inami, Jun Yamashita, Hitoshi Ogino, Masaru Hatano, Nobuhiro Yaoita, Nobutaka Ikeda, Hiroto Shimokawahara, Nobuhiro Tanabe, Kayoko Kubota, Ayako Shigeta, Yoshito Ogihara, Koshin Horimoto, Yoshihiro Dohi, Takashi Kawakami, Yuichi Tamura, Koichiro Tatsumi, Kohtaro Abe
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Abstract

Background: The management of chronic thromboembolic pulmonary hypertension (CTEPH) has advanced significantly in recent years, thereby improving patient prognosis. However, the impact of cancer on the outcomes of patients with CTEPH under current treatment remains unclear. This study aimed to investigate the prevalence of cancer in patients with CTEPH and determine how comorbid cancer affects their prognosis and clinical course.

Methods: Data from an ongoing Japanese prospective cohort study were analyzed. Prevalence and primary cancer sites were evaluated. The association of a history of cancer with a composite endpoint, including all-cause death, lung transplantation, and worsening of CTEPH, as well as venous thromboembolism and bleeding events, was assessed.

Results: Of the 1,270 patients in the cohort, 134 (10.6%) had a history of cancer, with the most common primary sites being the breast in women and the prostate in men. The incidence of composite outcome and all-cause death was higher in those with a history of cancer (p < 0.001, log-rank test). In the Cox proportional hazard model, age- and sex-adjusted hazard ratios for the composite outcome and all-cause death were 2.69 (95% confidence interval, 1.48-4.89, p = 0.001) and 4.25 (95% confidence interval, 1.98-9.10, p < 0.001), respectively, for patients with a history of cancer. No significant differences in venous thromboembolism and bleeding events were observed between patients with and those without a history of cancer.

Conclusions: A history of cancer, with a prevalence of 10.6%, is an independent risk factor for mortality in patients with CTEPH undergoing the currently recommended treatment.

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癌症是慢性血栓栓塞性肺动脉高压的独立死亡风险。
背景:近年来,慢性血栓栓塞性肺动脉高压(CTEPH)的治疗取得了重大进展,从而改善了患者的预后。然而,在目前的治疗方法中,癌症对 CTEPH 患者预后的影响仍不明确。本研究旨在调查癌症在 CTEPH 患者中的发病率,并确定合并癌症如何影响患者的预后和临床过程:方法:分析了一项正在进行的日本前瞻性队列研究的数据。方法:对一项正在进行的日本前瞻性队列研究的数据进行了分析,评估了癌症的发病率和原发部位。评估了癌症病史与综合终点(包括全因死亡、肺移植、CTEPH恶化以及静脉血栓栓塞和出血事件)之间的关系:在队列中的1270名患者中,134人(10.6%)有癌症病史,最常见的原发部位是女性的乳腺和男性的前列腺。有癌症病史的患者综合结果和全因死亡的发生率较高(p结论:癌症病史(发病率为 10.6%)是导致接受目前推荐治疗的 CTEPH 患者死亡的一个独立风险因素。
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来源期刊
CiteScore
10.10
自引率
6.70%
发文量
1667
审稿时长
69 days
期刊介绍: The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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