Statins and the Risk of Cancer After Heart Transplantation
Statins and the Risk of Cancer After Heart Transplantation
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DOI：
10.1161/circulationaha.111.081059
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发表时间：
2012-07-24
期刊：
影响因子：
37.8
通讯作者：
Ruschitzka, Frank
中科院分区：
文献类型：
--
作者：
Froehlich, Georg Marcus;Rufibach, Kaspar;Ruschitzka, Frank
背景-尽管新的免疫抑制剂，如mTOR(雷帕霉素的哺乳动物靶标)抑制剂，已经降低了移植后恶性肿瘤的发生，但癌症仍然是心脏移植后晚期死亡的主要原因。除降脂作用外，他汀类药物还可能对临床结果产生影响。本研究的目的是阐明他汀类药物治疗是否对心脏移植后的癌症风险和总死亡率有影响。方法和结果：本研究纳入了1985-2007年间在苏黎世大学医院接受心脏移植并在第一年存活的255名患者。主要的结果衡量标准是任何恶性肿瘤的发生；次要终点是总存活率。在随访期间，108名患者(42%)被诊断为恶性肿瘤。接受他汀类药物治疗的患者移植后8年肿瘤累积发生率降低(34%比13%；95%可信区间0.25-0.43比0.07-0.18；P
Background-Although newer immunosuppressive agents, such as mTOR (mammalian target of rapamycin) inhibitors, have lowered the occurrence of malignancies after transplantation, cancer is still a leading cause of death late after heart transplantation. Statins may have an impact on clinical outcomes beyond their lipid-lowering effects. The aim of the present study was to delineate whether statin therapy has an impact on cancer risk and total mortality after heart transplantation.Methods and Results-A total of 255 patients who underwent heart transplantation at the University Hospital Zurich between 1985 and 2007 and survived the first year were included in the present study. The primary outcome measure was the occurrence of any malignancy; the secondary end point was overall survival. During follow-up, a malignancy was diagnosed in 108 patients (42%). The cumulative incidence of tumors 8 years after transplantation was reduced in patients receiving a statin (34% versus 13%; 95% confidence interval, 0.25-0.43 versus 0.07-0.18; P