Cancer-related vulnerable lesions in patients with stable coronary artery disease
Cancer-related vulnerable lesions in patients with stable coronary artery disease
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稳定型冠状动脉疾病患者的癌症相关易损病变
DOI：
10.1016/j.ijcard.2021.03.050
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发表时间：
2021
影响因子：
3.5
通讯作者：
A
中科院分区：
文献类型：
--
作者：
Taruya Akira;Nakajima Yuki;Tanaka Atsushi;Kashiwagi Manabu;Tanimoto Takashi;Kuroi Akio;Shiono Yasutsugu;Shimamura Kunihiro;Kubo Takashi;Sougawa Hiromichi;Masuno Tomizo;Ozaki Yuichi;Satogami Keisuke;Ota Shingo;Katayama Yosuke;Ino Yasushi;Hoshiya Hironobu;A
研究背景冠状动脉疾病（coronary artery disease，CAD）已成为癌症患者发病和死亡的主要原因.目前尚不清楚癌症史是否影响病变特征。本研究的目的是探讨CAD患者的癌症相关病变形态。MethodsThis研究纳入了400例稳定CAD患者。患者分为癌症幸存者组（n= 69）和非癌症组（n= 331）。我们研究了冠状动脉病变形态光学相干断层扫描，我们评估的全因死亡率和主要不良心血管事件（MACE）方面的预后。癌症幸存者组的血清C反应蛋白水平显著高于非癌症组（癌症幸存者0.12 [0.05-0.42] mg/dL vs.非癌症0.08 [0.04-0.17] mg/dL，p= 0.019）。癌症幸存者组比非癌症组更容易发生血栓（癌症幸存者30.4%比非癌症组15.4%，p = 0.004）和分层纤维化斑块（LFPs;癌症幸存者18.8%比非癌症组3.6%，p < 0.0001）。癌症幸存者有较差的结果比非癌症对照组的全因死亡率（p= 0.020）和MACE（p= 0.036）。ConclusionsBecause潜在的炎症，CAD患者的癌症有更多的高危病变比那些没有癌症，这可能会导致前者的预后较差。这一结果可能为癌症患者CAD的二级预防提供信息。
BackgroundCoronary artery disease (CAD) has become a major cause of morbidity and mortality in cancer survivors. It is still unclear whether cancer history influences lesion characteristics. The purpose of this study was to investigate cancer-related lesion morphology in patients with CAD.MethodsThis study enrolled 400 patients with stable CAD. The patients were classified into a cancer survivor group (n= 69) and a noncancer group (n= 331). We investigated coronary lesion morphology by optical coherence tomography, and we assessed the prognosis in terms of both all-cause mortality and major adverse cardiovascular events (MACE).ResultsAdenocarcinoma was the most common histopathological diagnosis. Serum C-reactive protein levels were significantly higher in the cancer survivor group than in the noncancer group (cancer survivors 0.12 [0.05–0.42] mg/dL vs. noncancer 0.08 [0.04–0.17] mg/dL,p= 0.019). The cancer survivor group was more likely than the noncancer group to have thrombi (cancer survivors 30.4% vs. noncancer 15.4%,p= 0.004), and layered fibrotic plaques (LFPs; cancer survivors 18.8% vs. noncancer 3.6%,p< 0.0001). Cancer survivors had poorer outcomes than noncancer controls in terms of both all-cause mortality (p= 0.020) and MACE (p= 0.036).ConclusionsBecause of underlying inflammation, CAD patients with cancer had more high-risk lesions than those without cancer, which could result in poorer prognosis for the former. This result might inform the management of CAD in cancer patients in terms of secondary prevention.