Association of Life's Simple 7 with incident cardiovascular disease in 53 974 patients with cancer
Association of Life's Simple 7 with incident cardiovascular disease in 53 974 patients with cancer
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DOI：
10.1093/eurjpc/zwac195
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发表时间：
2022-09-03
影响因子：
8.3
通讯作者：
Komuro, Issei
中科院分区：
文献类型：
--
作者：
Kaneko, Hidehiro;Suzuki, Yuta;Komuro, Issei
癌症幸存者患心血管疾病（CVD）的风险更大。虽然Life's Simple 7用于一般人群的CVD风险分层，但其在癌症幸存者中的效用仍然未知。我们的目的是澄清癌症幸存者中Life's Simple 7与CVD事件的关联。此外，我们分析了生活简单7的变化与随后的CVD风险之间的关系。方法和结果这项回顾性观察性研究使用JMDC索赔数据库进行，我们分析了53974例既往有乳腺癌、结直肠癌或胃癌病史的患者，这些癌症是日本人群中常见的癌症部位。中位年龄为54岁，37.8%为男性。我们修改了Life's Simple 7的原始定义，并确定了以下理想的Life's Simple 7心血管健康指标：不吸烟，体重指数< 25 kg/m2，目标体力活动，最佳饮食习惯，未经治疗的空腹血糖< 100 mg/dL，未经治疗的血压< 120/80 mmHg，未经治疗的总胆固醇< 200 mg/dL。主要终点是复合CVD结局，包括心肌梗死、心绞痛、卒中和心力衰竭。在975 +/- 794天的平均随访期内，记录了3150例复合CVD结局。心血管事件的风险增加了更多的非理想生活的简单7。非理想生活简单7中每增加1分的风险比为1.15 [95%置信区间（CI）：1.12-1.18）。此外，1年内非理想生活简单7分增加1分与随后的CVD风险相关（风险比：1.12，95% CI：1.06-1.19）。结论Life's Simple 7可用于CVD危险分层，即使在癌症幸存者中也是如此。优化Life's Simple 7可以预防癌症幸存者的CVD发展。
Aims Cancer survivors have a greater risk of cardiovascular disease (CVD). Although Life's Simple 7 is used for CVD risk stratification in a general population, its utility in cancer survivors remains unknown. We aimed to clarify the association of Life's Simple 7 with incident CVD among cancer survivors. Furthermore, we analyzed the relationship between the change in Life's Simple 7 and the subsequent CVD risk. Methods and results This retrospective observational study was conducted using the JMDC Claims Database, and we analyzed 53 974 patients with a prior history of breast, colorectal, or stomach cancer, which is a common cancer site in the Japanese population. The median age was 54 years, and 37.8% were men. We modified the original definition of Life's Simple 7 and identified the following ideal Life's Simple 7 cardiovascular health metrics: non-smoking, body mass index < 25 kg/m(2), physical activity at goal, optimal dietary habits, untreated fasting plasma glucose < 100 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated total cholesterol < 200 mg/dL. The primary endpoint was composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure. Over a mean follow-up period of 975 +/- 794 days, 3150 composite CVD outcomes were recorded. The risk of CVD events increased with a greater number of non-ideal Life's Simple 7. The hazard ratio per 1-point increase in non-ideal Life's Simple 7 was 1.15 [95% confidence interval (CI): 1.12-1.18). Furthermore, a 1-point increase in non-ideal Life's Simple 7 over 1 year was associated with subsequent CVD risk (hazard ratio: 1.12, 95% CI: 1.06-1.19). Conclusion Life's Simple 7 could be applicable for CVD risk stratification even among cancer survivors. Optimizing Life's Simple 7 may prevent the development of CVD in cancer survivors.