Lifestyle and Cardiovascular Risk Factors Associated With Heart Failure Subtypes in Postmenopausal Breast Cancer Survivors.
Lifestyle and Cardiovascular Risk Factors Associated With Heart Failure Subtypes in Postmenopausal Breast Cancer Survivors.
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DOI：
10.1016/j.jaccao.2022.01.099
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发表时间：
2022-03
影响因子：
11.1
通讯作者：
Anderson, Garnet
中科院分区：
文献类型：
--
作者：
Reding, Kerryn W.;Cheng, Richard K.;Vasbinder, Alexi;Ray, Roberta M.;Barac, Ana;Eaton, Charles B.;Saquib, Nazmus;Shadyab, Aladdin H.;Simon, Michael S.;Langford, Dale;Branch, Mary;Caan, Bette;Anderson, Garnet
乳腺癌 (BC) 幸存者的长期合并症负担增加，包括心力衰竭 (HF)。然而，对于 BC 幸存者发生 HF 亚型（例如射血分数保留的 HF (HFpEF)）的风险了解有限。本研究旨在估计绝经后 BC 幸存者中 HFpEF 和射血分数降低的 HF (HFrEF) 的发生率，并确定与 HF 亚型相关的生活方式和心血管危险因素。在妇女健康倡议中，对被裁定诊断为侵入性 BC 的参与者进行跟踪以确定住院心力衰竭的发生率，其中裁定程序确定了左心室射血分数。我们计算了 HF、HFpEF 和 HFrEF 的累积发生率。我们使用 Cox 比例风险生存模型估计了与 HF、HFpEF 和 HFrEF 相关的危险因素的 HR。在 2,272 名 BC 幸存者（28.6% 黑人和 64.9% 白人）中，住院 HFpEF 和 HFrEF 的累积发生率分别为 6.68% 和 3.96%，中位数为 7.2 年（IQR：3.6-12.3 年）。对于 HFpEF，既往心肌梗死（HR：2.83；95% CI：1.28-6.28）、腰围较大（HR：1.99；95% CI：1.14-3.49）和吸烟史（HR：1.65；95% CI：1.01-2.67）是多变量模型中最强的危险因素。除腰围外，HFrEF 也观察到类似的模式，但不显着。与无 HF 的患者相比，住院 HFpEF 的 BC 幸存者的总体死亡率风险为 5.65 (95% CI: 4.11-7.76)，而住院 HFrEF 的患者总体死亡率风险为 3.77 (95% CI: 2.51-5.66)。在这个年龄较大、种族多样化的 BC 幸存者群体中，根据 HF 住院定义，HFpEF 的发生率高于 HFrEF。心力衰竭还与死亡风险增加相关。除了 HFpEF 既往有心肌梗死史之外，心力衰竭的危险因素与一般人群基本相似。值得注意的是，腰围和吸烟都是潜在的可改变因素。
Breast cancer (BC) survivors experience an increased burden of long-term comorbidities, including heart failure (HF). However, there is limited understanding of the risk for the development of HF subtypes, such as HF with preserved ejection fraction (HFpEF), in BC survivors. This study sought to estimate the incidence of HFpEF and HF with reduced ejection fraction (HFrEF) in postmenopausal BC survivors and to identify lifestyle and cardiovascular risk factors associated with HF subtypes. Within the Women’s Health Initiative, participants with an adjudicated diagnosis of invasive BC were followed to determine the incidence of hospitalized HF, for which adjudication procedures determined left ventricular ejection fraction. We calculated cumulative incidences of HF, HFpEF, and HFrEF. We estimated HRs for risk factors in relation to HF, HFpEF, and HFrEF using Cox proportional hazards survival models. In 2,272 BC survivors (28.6% Black and 64.9% White), the cumulative incidences of hospitalized HFpEF and HFrEF were 6.68% and 3.96%, respectively, over a median of 7.2 years (IQR: 3.6-12.3 years). For HFpEF, prior myocardial infarction (HR: 2.83; 95% CI: 1.28-6.28), greater waist circumference (HR: 1.99; 95% CI: 1.14-3.49), and smoking history (HR: 1.65; 95% CI: 1.01-2.67) were the strongest risk factors in multivariable models. With the exception of waist circumference, similar patterns were observed for HFrEF, although none were significant. In relation to those without HF, the risk of overall mortality in BC survivors with hospitalized HFpEF was 5.65 (95% CI: 4.11-7.76), and in those with hospitalized HFrEF, it was 3.77 (95% CI: 2.51-5.66). In this population of older, racially diverse BC survivors, the incidence of HFpEF, as defined by HF hospitalizations, was higher than HFrEF. HF was also associated with an increased mortality risk. Risk factors for HF were largely similar to the general population with the exception of prior myocardial infarction for HFpEF. Notably, both waist circumference and smoking represent potentially modifiable factors.
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DOI：
10.1161/circimaging.116.004950
发表时间：
2016-09
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Nadruz W Jr;Claggett B;Gonçalves A;Querejeta-Roca G;Fernandes-Silva MM;Shah AM;Cheng S;Tanaka H;Heiss G;Kitzman DW;Solomon SD
通讯作者：
Solomon SD
影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
影响因子：
2.2
作者：
Reding KW;Ghemigian K;Carbone S;D'Agostino R Jr;Jordan JH;Meléndez G;Lamar ZS;Klepin HD;Thomas A;Langford D;Vasu S;Hundley WG
通讯作者：
Hundley WG
影响因子：
24
作者：
Fonarow, Gregg C.;Stough, Wendy Gattis;Young, James B.
通讯作者：
Young, James B.
影响因子：
37.8
作者：
Cardinale, Daniela;Colombo, Alessandro;Cipolla, Carlo M.
通讯作者：
Cipolla, Carlo M.