Jacc: Cardiooncology最新文献

英文中文

Atherosclerotic Cardiovascular Diseases Are Associated With Incident Metastatic and Nonmetastatic Cancer 动脉粥样硬化性心血管疾病与转移性和非转移性癌症相关

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.07.020

Tal Caller MSc , Alexander Fardman MD , Yariv Gerber PhD , Yonatan Moshkovits BSc , Shmuel Tiosano MD , Alon Kaplan BSc , Maia Kalstein BSc , Gabriella Bayshtok BSc , Tomer Itkin PhD , Abraham Avigdor MD , Nili Naftali-Shani PhD , Jonathan Leor MD , Elad Maor MD, PhD

Background

Cardiovascular diseases are associated with higher cancer risk. However, their relationship with metastatic cancer, the primary determinant of cancer prognosis, has not been studied.

Objectives

This study aimed to determine the association between atherosclerotic cardiovascular disease and the presence of metastasis at the time of cancer diagnosis.

Methods

We analyzed data from 21,654 self-referred adults who were free of cancer and atherosclerotic cardiovascular disease at enrollment in a preventive health care program. To exclude silent cancers, a 1-year blanking period was implemented at the start of the follow-up. The relationship between atherosclerotic cardiovascular disease and metastatic cancer was assessed using cause-specific Cox regression, treating incident atherosclerotic cardiovascular disease as a time-dependent covariate. Interaction analysis further elucidated differences in metastasis risks between middle-aged adults (Q1-Q3 age ≤54 years) and older adults (Q4 age >54 years).

Results

Over a median follow-up of 6 years (Q1-Q3: 3-12 years), we recorded 1,333 cases of atherosclerotic cardiovascular disease (6.2%) and 1,793 cases of cancer (8.3%), of which 1,036 (4.8 %) were nonmetastatic and 757 (3.5%) were metastatic at diagnosis. After adjusting for shared risk factors, atherosclerotic cardiovascular disease was independently associated with an increased risk of cancer metastasis at the time of cancer diagnosis (HR: 1.75; 95% CI: 1.33-2.29). This association was more pronounced among middle-aged adults (HR: 1.64; 95% CI: 1.03-2.61; P = 0.036) than in older adults (HR: 1.11; 95% CI: 0.78-1.60; P = 0.56), with a significant interaction (P_interaction = 0.039).

Conclusions

Atherosclerotic cardiovascular disease is associated with a significantly increased risk of cancer, specifically metastasis at the time of cancer diagnosis, particularly in middle-aged adults. Recognizing this association could enhance the prevention and treatment of metastatic cancer in patients with atherosclerotic cardiovascular disease.

背景：心血管疾病与较高的癌症风险相关。然而，它们与转移性癌症（癌症预后的主要决定因素）的关系尚未得到研究。目的：本研究旨在确定动脉粥样硬化性心血管疾病与癌症诊断时是否存在转移之间的关系。方法：我们分析了21,654名自我推荐的成年人的数据，这些成年人在参加预防保健计划时没有癌症和动脉粥样硬化性心血管疾病。为了排除无症状的癌症，在随访开始时实施了1年的空白期。使用病因特异性Cox回归评估动脉粥样硬化性心血管疾病与转移性癌症之间的关系，将动脉粥样硬化性心血管疾病事件作为时间依赖的协变量。相互作用分析进一步阐明了中年人（Q1-Q3年龄≤54岁）和老年人（Q4年龄bb0 - 54岁）之间转移风险的差异。结果：在中位随访6年（Q1-Q3: 3-12年）期间，我们记录了1333例动脉粥样硬化性心血管疾病（6.2%）和1793例癌症（8.3%），其中1036例（4.8%）为非转移性，757例（3.5%）为诊断时转移性。在调整了共同的危险因素后，动脉粥样硬化性心血管疾病与癌症诊断时癌症转移风险增加独立相关(HR: 1.75；95% ci: 1.33-2.29)。这种关联在中年人中更为明显(HR: 1.64；95% ci: 1.03-2.61；P = 0.036)高于老年人(HR: 1.11；95% ci: 0.78-1.60；P = 0.56)，交互作用显著（P交互作用= 0.039）。结论：动脉粥样硬化性心血管疾病与癌症风险显著增加相关，特别是在癌症诊断时转移，特别是在中年人中。认识到这种关联可以加强对动脉粥样硬化性心血管疾病患者转移性癌症的预防和治疗。

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引用次数: 0

Cancer Prevention and Early Detection in Patients With Cardiovascular Disease 心血管疾病患者的癌症预防和早期发现：双向心脏肿瘤学的目标。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.09.009

Pietro Ameri MD, PhD , Susan Dent MD

引用次数: 0

Net Clinical Benefit of 12-Month Over 3-Month Edoxaban in Cancer-Associated Isolated Distal Deep Vein Thrombosis 12个月比3个月依多沙班治疗癌症相关孤立性远端深静脉血栓的净临床获益

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.07.019

Yuji Nishimoto MD , Yugo Yamashita MD , Takeshi Morimoto MD, MPH , Nao Muraoka MD , Michihisa Umetsu MD , Takuma Takada MD , Yoshito Ogihara MD , Tatsuya Nishikawa MD , Nobutaka Ikeda MD , Yukihito Sato MD , Takahisa Yamada MD , Takeshi Kimura MD , ONCO DVT Study Investigators

引用次数: 0

SGLT2 Inhibitors in Mitigating Cancer Therapy-Related Cardiac Dysfunction SGLT2抑制剂减轻癌症治疗相关心功能障碍：扩大证据。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.10.005

Mohamed S. Dabour MS , Anne H. Blaes MD, MS , Bhavadharini Ramu MD , Beshay N. Zordoky MS, PhD

引用次数: 0

Cancer Diagnosis, Physical Activity, and Heart Disease Risk 癌症诊断、体育活动和心脏病风险。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.11.002

Emmanuel Stamatakis PhD , Nicholas A. Koemel PhD , Raaj K. Biswas PhD , Matthew N. Ahmadi PhD

引用次数: 0

Cardiovascular Considerations During Cancer Therapy 癌症治疗中的心血管因素：证据和JACC的差距：心血管肿瘤学专家小组的建议。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.06.005

Darryl P. Leong MBBS, MPH, MBiostat, PhD , Sarah Waliany MD, MS , Husam Abdel-Qadir MD, PhD , Katelyn M. Atkins MD, PhD , Tomas G. Neilan MD, MPH , Ninian N. Lang MB ChB, PhD , Jennifer E. Liu MD , Anne H. Blaes MD, MS , Hira S. Mian MD , Heather N. Moore PharmD, BCOP, CPP , Ludhmila A. Hajjar MD , Alicia K. Morgans MD, MPH , Peter M. Ellis MBBS, MMed, PhD , Susan Dent MD

The administration of certain cancer therapies can be associated with the development of cardiovascular toxicity or complications. This spectrum of toxicities is broad and requires nuanced approaches for prevention, identification, and management. This expert panel summarizes the consensus of opinions of diverse health care professionals in several key areas: 1) cardioprotection involves strategies aimed at the primary prevention of cancer therapy–related cardiovascular toxicity; 2) surveillance entails monitoring for cancer therapy–related cardiovascular toxicity during cancer therapy; 3) permissive cardiotoxicity is the informed continuation of cancer therapy in the presence of cardiovascular toxicity, along with the implementation of mitigating cardiovascular treatments; and 4) special considerations include the invasive management of severe cardiovascular disease in patients receiving treatments for advanced cancer and the exploration of drug-drug interactions in cardio-oncology. In this expert panel, we also highlight gaps in evidence in an effort to continue to advance science in the cardiovascular care of our patients undergoing cancer therapy.

使用某些癌症疗法可能会引起心血管毒性或并发症。这种毒性的范围很广，需要细致入微的预防、识别和管理方法。本专家小组总结了不同医护人员在几个关键领域的共识：1）心脏保护涉及癌症治疗相关心血管毒性的一级预防策略；2）监测包括在癌症治疗过程中监测癌症治疗相关心血管毒性；3）允许性心脏毒性是指在知情的情况下继续进行癌症治疗，同时实施减轻心血管毒性的治疗方法；4）特殊考虑包括对接受晚期癌症治疗的严重心血管疾病患者进行侵入性管理，以及探索心肿瘤学中的药物相互作用。在本专家小组中，我们还强调了证据方面的差距，以继续推进对接受癌症治疗的患者进行心血管治疗的科学研究。

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引用次数: 0

Elucidating the Signal from the Noise 从噪声中解析信号：心脏传导事件映射到心脏亚结构辐射暴露。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.10.007

Florence K. Keane MD , Tomas G. Neilan MD, MPH , Rachel B. Jimenez MD

引用次数: 0

Multimodality Imaging in the Diagnostic Work-Up of Patients With Cardiac Masses 心脏肿块患者的多模态成像诊断：JACC：心脏肿瘤学最新进展综述。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.09.006

Francesco Angeli MD , Francesca Bodega MD , Luca Bergamaschi MD , Matteo Armillotta MD , Sara Amicone MD , Lisa Canton MD , Damiano Fedele MD , Nicole Suma MD , Daniele Cavallo MD , Alberto Foà MD, PhD , Marta Belmonte MD , Vincenzo Russo MD , Domenico Attinà MD , Fabio Niro MD , Rachele Bonfiglioli MD , Stefano Fanti MD , Anna Giulia Pavon MD , Marco Guglielmo MD , Saima Mushtaq MD , Maria Abbondanza Pantaleo MD , Carmine Pizzi MD

Cardiac masses encompass a diverse range of benign and malignant tumors as well as pseudotumors. Accurate histologic identification is essential for guiding appropriate treatment, yet the diagnostic process remains challenging. Although biopsy is traditionally the diagnostic gold standard, its invasive nature and associated risks limit its application. A noninvasive multimodality imaging approach has recently emerged as an alternative, but standardized protocols and supporting evidence are still lacking. Echocardiography is typically the initial imaging modality, with cardiac magnetic resonance recognized as the noninvasive diagnostic gold standard. Cardiac computed tomography provides complementary data to aid in diagnosis and management, while positron emission tomography serves as a third-level imaging option. This state-of-the-art review highlights the role of current multimodality imaging techniques in diagnosing and managing cardiac masses and explores future directions for their applications.

心脏肿块包括各种良性和恶性肿瘤以及假肿瘤。准确的组织学鉴定对于指导适当的治疗至关重要，但诊断过程仍然具有挑战性。虽然活检传统上是诊断的金标准，但其侵入性和相关风险限制了其应用。最近出现了一种非侵入性多模态成像方法作为替代方法，但标准化的方案和支持证据仍然缺乏。超声心动图通常是最初的成像方式，心脏磁共振被认为是无创诊断的金标准。心脏计算机断层扫描提供补充数据，以帮助诊断和管理，而正电子发射断层扫描作为第三级成像选择。这篇最新的综述强调了当前多模态成像技术在诊断和管理心脏肿块中的作用，并探讨了其应用的未来方向。

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引用次数: 0

SGLT2i and Primary Prevention of Cancer Therapy–Related Cardiac Dysfunction in Patients With Diabetes SGLT2i与糖尿病患者癌症治疗相关心功能障碍的一级预防

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.08.001

Ammar W. Bhatti DO , Rushin Patel MD , Sourbha S. Dani MD , Sumanth Khadke MD , Bhargav Makwana MD , Candace Lessey MD , Jui Shah MD , Zaid Al-Husami MD , Eric H. Yang MD , Paaladinesh Thavendiranathan MD, SM , Tomas G. Neilan MD , Diego Sadler MD , Richard K. Cheng MD, MSc , Susan F. Dent MD , Jennifer Liu MD , Teresa Lopez-Fernandez MD , Joerg Herrmann MD , Marielle Scherrer-Crosbie MD, PhD , Daniel J. Lenihan MD , Salim S. Hayek MD , Sarju Ganatra MD

Background

Specific cancer treatments can lead to cancer therapy–related cardiac dysfunction (CTRCD). Sodium glucose cotransporter-2 inhibitors (SGLT2is) can potentially prevent these cardiotoxic effects.

Objectives

This study sought to determine whether SGLT2i use is associated with a lower incidence of CTRCD in patients with type 2 diabetes mellitus (T2DM) and cancer, exposed to potentially cardiotoxic antineoplastic agents, and without a prior documented history of cardiomyopathy or heart failure.

Methods

We conducted a retrospective analysis of patients aged ≥18 years within the TriNetX database with T2DM, cancer, exposure to cardiotoxic therapies, and no prior documented history of cardiomyopathy or heart failure. Patients were categorized by SGLT2i use. After propensity score matching, outcomes were compared over 12 months using Cox proportional HRs. Subgroup analyses focusing on different cancer therapy classes were performed.

Results

The study included 8,675 propensity-matched patients in each cohort (mean age = ∼65 years, 42% females, 71% White, ∼19% gastrointestinal malignancy, and ∼25% anthracyclines). Patients prescribed SGLT2is had a lower risk of developing CTRCD (HR: 0.76: 95% CI: 0.69-0.84). SGLT2is also reduced heart failure exacerbations (HR: 0.81; 95% CI: 0.72-0.90), all-cause mortality (HR: 0.67; 95% CI: 0.61-0.74), and all-cause hospitalizations/emergency department visits (HR: 0.93; 95% CI: 0.89-0.97). Subgroup analyses also demonstrated reduced CTRCD risk across various classes of cancer therapies in patients prescribed SGLT2is.

Conclusions

SGLT2i administration was associated with a significantly decreased risk of developing CTRCD in patients with T2DM and cancer.

背景：特定的癌症治疗可导致癌症治疗相关的心功能障碍（CTRCD）。钠葡萄糖共转运体-2抑制剂（SGLT2i）有可能预防这些心脏毒性效应：本研究旨在确定使用 SGLT2i 是否与 2 型糖尿病（T2DM）和癌症患者较低的 CTRCD 发生率有关：我们对 TriNetX 数据库中年龄≥18 岁、患有 T2DM、癌症、接触过心脏毒性抗肿瘤药物且无心肌病或心力衰竭病史记录的患者进行了回顾性分析。患者按使用 SGLT2i 进行分类。经过倾向评分匹配后，使用 Cox 比例 HRs 对 12 个月内的结果进行比较。研究还针对不同的癌症治疗类别进行了分组分析：该研究在每个队列中纳入了8675名倾向匹配患者（平均年龄=∼65岁，42%为女性，71%为白人，∼19%为胃肠道恶性肿瘤，∼25%为蒽环类药物）。服用 SGLT2is 的患者罹患 CTRCD 的风险较低（HR：0.76：95% CI：0.69-0.84）。SGLT2is 还降低了心衰加重（HR：0.81；95% CI：0.72-0.90）、全因死亡率（HR：0.67；95% CI：0.61-0.74）和全因住院/急诊就诊率（HR：0.93；95% CI：0.89-0.97）。亚组分析还显示，服用SGLT2i的患者接受各类癌症治疗的CTRCD风险降低：结论：服用 SGLT2i 可显著降低 T2DM 和癌症患者罹患 CTRCD 的风险。

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引用次数: 0

Deep Inspiration Breath Hold to Reduce Cardiovascular Disease Risk for Breast Radiotherapy 深吸气屏气降低乳腺放疗的心血管疾病风险：挑战与机遇。

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology

Pub Date : 2024-12-01 DOI: 10.1016/j.jaccao.2024.08.009

Shanshan Gao MD , Jian Zhang MD , Beina Hui MD , Weibin Hu MD , Yongkai Lu PhD

引用次数: 0

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