Incidence of cardiovascular events in breast cancer patients receiving chemotherapy in clinical practice
Incidence of cardiovascular events in breast cancer patients receiving chemotherapy in clinical practice
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DOI：
10.1002/pds.1528
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发表时间：
2008-02-01
影响因子：
2.6
通讯作者：
Herings, Ron M. C.
中科院分区：
文献类型：
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作者：
Sukel, Myrthe P. P.;Breekveldt-Postma, Nancy S.;Herings, Ron M. C.
目的评估乳腺癌化疗后心血管事件的发生率。方法从PHARMO RLS中选择1992-2003年接受化疗的18岁乳腺癌患者。使用蒽环类药物化疗，联合使用蒽环类药物和紫杉烷类药物，或使用曲妥珠单抗进行二线治疗，被归类为心脏毒性。心血管事件是根据药物使用和住院情况确定的。在第一年和整个随访期间，评估心脏毒性化疗组和非心脏毒性化疗组的心血管事件发生率和风险比(HR)。结果在研究队列中的648例乳腺癌患者中，353例(54%)接受了心脏毒性化疗。在基线情况下，接受心脏毒性化疗的患者与接受非心脏毒性化疗的患者相比，接受抗凝剂/止血药的患者较少(5%比11%；p=0.012)，在队列进入日期前两年因心血管疾病住院的频率更低(1vs.5%；p=0.007)。随访1年，心脏毒性化疗组心血管事件发生率为69/1000人年，非心脏毒性化疗组为98/1000人年，差异无统计学意义(HR=0.74，95%可信区间：0.39，1.41)。总随访期心脏毒性患者为81/1000Py，非心脏毒性化疗组为92/1000Py(HR 0.81，95%CI：0.54，1.20)。结论乳腺癌患者心脏毒性化疗和非心脏毒性化疗患者的随访期心血管并发症发生率相似。在治疗乳腺癌患者时，专家们似乎将先前存在的心血管疾病考虑在内。版权所有(C)2007 John Wiley&Sons，Ltd.
Purpose To assess the incidence of cardiovascular events among breast cancer patients after chemotherapy.Methods Women >= 18 years with a breast tumour who received chemotherapy in 1992-2003 were selected from the PHARMO RLS. Chemotherapy with anthracyclines, a combination of anthracyclines and taxanes or second line treatment with trastuzumab was classified as cardiotoxic. Cardiovascular events were determined based on drug use and hospital admissions. Incidence rates of cardiovascular events and hazard ratios (HR) for the cardiotoxic versus non-cardiotoxic chemotherapy group were assessed during the first year and total follow-up.Results Of 648 patients with breast cancer included in the study cohort, 353 (54%) received cardiotoxic chemotherapy. At baseline, patients who received cardiotoxic chemotherapy compared with patients receiving non-cardiotoxic chemotherapy, received less anticoagulants/haemostatics (5 vs. 11%; p = 0.012) and had been less often hospitalised for cardiovascular disease (1 vs. 5%; p = 0.007) 2 years before the cohort entry date. After 1-year follow-up, the incidence rate of cardiovascular events was 69/1000person years (py) for patients with cardiotoxic chemotherapy and 98/1000py for patients with non-cardiotoxic chemotherapy, which did not differ significantly (HR 0.74 95% confidence interval (CI): 0.39, 1.41). After total follow-up, this was 81/1000 py for patients with cardiotoxic and 92/1000 py for patients with non-cardiotoxic chemotherapy (HR 0.81, 95%CI: 0.54, 1.20).Conclusions This study showed similar cardiovascular incidence rates during follow-up for breast cancer patients treated with cardiotoxic and non-cardiotoxic chemotherapy. Specialists seemed to take pre-existing cardiovascular diseases into account when treating the breast cancer patient. Copyright (C) 2007 John Wiley & Sons, Ltd.