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Life’s Essential 8 and Incident Cardiovascular Disease in U.S. Women With Breast Cancer 生活必需品 8 和美国乳腺癌妇女的心血管疾病发病率
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.008

Background

Relationships between lifestyle risk factors and cardiovascular disease (CVD) risk in women with breast cancer (BC) are underexplored.

Objectives

To evaluate the incidence of CVD in relation to the Life’s Essential 8 (LE8) score among women with BC.

Methods

Data from the Women’s Health Initiative were utilized. The primary exposure was the LE8 score assessed prior to BC diagnosis. The LE8 score was stratified into low (0-59), moderate (60-79), and high (80-100) cardiovascular health (CVH). The primary endpoint was a composite of incident CVD events, which included coronary heart disease, defined as myocardial infarction along with coronary revascularization, CVD death, and stroke. We calculated the cumulative incidence of CVD and estimated hazard ratios.

Results

Among 7,165 participants, the median age was 70.1 years at BC diagnosis. The mean LE8 score was 62.0 ± 12.2. Over a median follow-up period of 6 years, 490 composite CVD events occurred. The risk of CVD events was highest for low CVH compared with moderate and high CVH. Compared with low CVH, the hazard ratio for incident CVD was 0.57 (95% CI: 0.46-0.69) for moderate CVH and 0.34 (95% CI: 0.20-0.59) for high CVH. LE8, in conjunction with age, provided a C-statistic of 0.74 for the composite risk of CVD.

Conclusions

Higher LE8 scores were associated with a lower risk of incident CVD among women with BC in the United States.
背景对乳腺癌(BC)女性患者的生活方式风险因素与心血管疾病(CVD)风险之间的关系探索不足。主要暴露是在 BC 诊断前评估的 LE8 分数。LE8 分值被分为低(0-59 分)、中(60-79 分)和高(80-100 分)心血管健康(CVH)等级。主要终点是心血管疾病事件的综合指数,其中包括冠心病(定义为心肌梗死和冠状动脉血运重建)、心血管疾病死亡和中风。我们计算了心血管疾病的累积发病率,并估算了危险比。结果在 7,165 名参与者中,确诊 BC 时的中位年龄为 70.1 岁。LE8 评分的平均值为 62.0 ± 12.2。中位随访期为 6 年,共发生 490 起心血管疾病综合事件。与中度和高度CVH相比,低CVH发生心血管事件的风险最高。与低 CVH 相比,中度 CVH 发生心血管事件的危险比为 0.57(95% CI:0.46-0.69),高度 CVH 为 0.34(95% CI:0.20-0.59)。结论美国 BC 女性患者中,LE8 评分越高,发生心血管疾病的风险越低。
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引用次数: 0
Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes for Preclinical Cardiotoxicity Screening in Cardio-Oncology 用于心肿瘤临床前心脏毒性筛选的人类诱导多能干细胞衍生心肌细胞
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.012
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引用次数: 0
Measuring “Cardiovascular Health” in Everyone Including Cancer Patients 衡量包括癌症患者在内的所有人的 "心血管健康 "状况
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.08.003
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引用次数: 0
Preventing Cancer Therapy–Related Cardiotoxicity 预防与癌症治疗相关的心脏毒性
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.09.001
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引用次数: 0
Steroids in Immune Checkpoint Inhibitor Myocarditis 类固醇在免疫检查点抑制剂心肌炎中的应用
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.002
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引用次数: 0
Body Composition During Androgen Deprivation Therapy in Prostate Cancer 前列腺癌雄激素剥夺疗法期间的身体组成
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.08.004
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引用次数: 0
Autonomic Dysfunction Among Adult Survivors of Childhood Cancer 儿童癌症成年幸存者的自主神经功能障碍
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.09.004
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引用次数: 0
Rarefaction of Blood, But Not Lymphatic Capillaries, in Patients With Cardiac Amyloidosis 心脏淀粉样变性患者的血液稀释,而非淋巴毛细血管稀释
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.009
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引用次数: 0
Cardiac Troponin I and T in ICI Myocarditis Screening, Diagnosis, and Prognosis 心肌肌钙蛋白 I 和 T 在 ICI 心肌炎筛查、诊断和预后中的应用
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.001
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引用次数: 0
Anthracycline Cardiotoxicity in Adult Cancer Patients 成人癌症患者的蒽环类药物心脏毒性
IF 12 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 DOI: 10.1016/j.jaccao.2024.07.016
Since their introduction in the 1960s, anthracyclines have been a significant breakthrough in oncology, introducing dramatic changes in the treatment of solid and hematologic malignancies. Although new-generation targeted drugs and cellular therapies are revolutionizing contemporary oncology, anthracyclines remain the cornerstone of treatment for lymphomas, acute leukemias, and soft tissue sarcomas. However, their clinical application is limited by a dose-dependent cardiotoxicity that can reduce cardiac performance and eventually lead to overt heart failure. The field of cardio-oncology has emerged to safeguard the cardiovascular health of cancer patients receiving these therapies. It focuses on controlling risk factors, implementing preventive strategies, ensuring appropriate surveillance, and managing complications. This state-of-the-art review summarizes the current indications for anthracyclines in modern oncology, explores recent evidence on pathophysiology and epidemiology, and discusses advances in cardioprotection measures in the anthracycline-treated patient. Additionally, it highlights key clinical challenges and research gaps in this area.
自 20 世纪 60 年代问世以来,蒽环类药物在肿瘤学领域取得了重大突破,为实体瘤和血液系统恶性肿瘤的治疗带来了巨大变化。虽然新一代靶向药物和细胞疗法正在彻底改变当代肿瘤学,但蒽环类药物仍然是治疗淋巴瘤、急性白血病和软组织肉瘤的基石。然而,蒽环类药物的临床应用受到剂量依赖性心脏毒性的限制,这种毒性会降低心脏功能,最终导致明显的心力衰竭。为了保护接受这些疗法的癌症患者的心血管健康,肿瘤心脏病学领域应运而生。其重点是控制风险因素、实施预防策略、确保适当的监测以及控制并发症。这篇最新综述总结了蒽环类药物在现代肿瘤学中的适应症,探讨了病理生理学和流行病学方面的最新证据,并讨论了蒽环类药物治疗患者心血管保护措施的进展。此外,它还强调了这一领域的主要临床挑战和研究空白。
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引用次数: 0
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Jacc: Cardiooncology
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