Cancer and cardiovascular disease: The impact of cardiac rehabilitation and cardiorespiratory fitness on survival.
Cancer and cardiovascular disease: The impact of cardiac rehabilitation and cardiorespiratory fitness on survival.
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DOI：
10.1016/j.ijcard.2021.09.004
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发表时间：
2021-11-15
影响因子：
3.5
通讯作者：
Laddu, Deepika
中科院分区：
文献类型：
--
作者：
Williamson, Tamara;Moran, Chelsea;Chirico, Daniele;Arena, Ross;Ozemek, Cemal;Aggarwal, Sandeep;Campbell, Tavis;Laddu, Deepika
关键词：
癌症幸存者的心血管疾病（CVD）相关的发病率和死亡率的风险增加。基于运动的心脏康复（CR）计划可改善CVD风险因素，包括心肺功能（CRF）。本研究的目的是调查：（1）CR完成与生存率之间的关系，以及（2）CRF改善是否转化为癌症和CVD共病患者生存率的增加。CVD和既存癌症（任何类型）患者在1996年1月至2016年3月期间接受了为期12周的基于运动的CR计划。在CR前和12周时通过分级运动试验评估峰值代谢当量（MET）。进行Kaplan-Meier生存期和多变量考克斯回归，以评价CR完成和具有临床意义的CRF改善[Δ MET ≥1]对生存期的影响，并对相关协变量进行调整。在442名接受CR的心血管疾病和癌症患者中（67 ± 10岁; 22%女性），361名（82%）完成CR。在12年的观察期内记录了102例死亡。与未完成CR的患者相比，完成CR的共病癌症患者表现出生存优势（63% vs 80.1%，p <0.001）。在12周的项目期间，完成者的CRF改善（平均变化= 0.87 ± 0.93 MET，p <0.001）; 41%的患者出现了具有临床意义的Δ MET ≥1。在Δ MET改善≥1的完成者中未观察到生存优势（p = .254）。完成12周基于运动的CR计划改善了CVD和共病癌症患者的CRF并增加了生存率。研究结果强调了在经历癌症治疗和生存带来的额外障碍的CVD患者中完成CR计划的生存益处。
Cancer survivors are at increased risk for cardiovascular disease (CVD)-related morbidity and mortality. Exercise-based cardiac rehabilitation (CR) programs improve CVD risk factors, including cardiorespiratory fitness (CRF). The purpose of this study was to investigate: (1) the association between CR completion and survival, and (2) whether CRF improvements translate to increased survival among patients with comorbid cancer and CVD. Patients with CVD and pre-existing cancer (any type) were referred to a 12-week exercise-based CR program between 01/1996 and 03/2016. Peak metabolic equivalents (METs) were assessed by graded exercise test pre-CR and at 12-weeks. Kaplan-Meier survival and multivariate cox regressions were performed to evaluate impact of CR completion and clinically-meaningful CRF improvements [ΔMETs≥1] on survival, adjusting for relevant covariates. Among 442 patients with CVD and cancer referred to CR (67 ± 10 years; 22% women), 361 (82%) completed CR. 102 deaths were recorded during the 12-year observation period. Compared to patients who did not complete CR, patients with comorbid cancer who completed CR demonstrated a survival advantage (63% vs 80.1%, p < .001). CRF improved among completers during the 12-week program (mean change = 0.87 ± 0.93 METs, p < .001); 41% experienced a clinically-meaningful ΔMETs≥1. A survival advantage was not observed in completers who experienced a ΔMETs≥1 improvement (p = .254). Completing a 12-week exercise-based CR program improved CRF and increased survival in patients with CVD and comorbid cancer. The results highlight the survival benefits of completing a CR program among CVD patients who experience added barriers imposed by cancer treatment and survival.
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影响因子：
37.8
作者：
Martin, Billie-Jean;Hauer, Trina;Aggarwal, Sandeep G.
通讯作者：
Aggarwal, Sandeep G.
影响因子：
16.2
作者：
Graham, MM;Ghali, WA;Knudtson, ML
通讯作者：
Knudtson, ML
DOI：
10.14694/edbk_175349
发表时间：
2017-01-01
期刊：
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
影响因子：
--
作者：
Haykowsky, Mark J;Scott, Jessica M;Denduluri, Neelima
通讯作者：
Denduluri, Neelima
影响因子：
2.9
作者：
Hubbard G;Adams R;Campbell A;Kidd L;Leslie SJ;Munro J;Watson A
通讯作者：
Watson A
影响因子：
3.5
作者：
Sandercock, Gavin;Hurtado, Valentina;Cardoso, Fernando
通讯作者：
Cardoso, Fernando