Performance of the pooled cohort equations in cancer survivors: the Atherosclerosis Risk in Communities study.
Performance of the pooled cohort equations in cancer survivors: the Atherosclerosis Risk in Communities study.
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癌症幸存者中汇总队列方程的表现：社区动脉粥样硬化风险研究。
DOI：
10.1007/s11764-023-01379-0
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Prizment,Anna
中科院分区：
文献类型：
--
作者：
Polter,ElizabethJ;Blaes,Anne;Wolfson,Julian;Lutsey,PamelaL;Florido,Roberta;Joshu,CorinneE;Guha,Avirup;Platz,ElizabethA;Prizment,Anna
背景癌症幸存者可能有升高的动脉粥样硬化性心血管疾病（ASCVD）风险。因此，我们认为，我们测试了美国心脏病学会/美国心脏协会2013年合并队列方程（PCE）预测癌症幸存者10年ASCVD风险的准确性。我们在1244名癌症幸存者和3849名在随访开始时没有ASCVD的无癌症参与者中评估了PCE的性能。每个癌症幸存者的发病率密度与年龄，种族，性别和研究中心的五个对照组相匹配。随访从癌症幸存者诊断日期后至少1年的首次研究访视开始，并在ASCVD事件、死亡或随访结束时结束。校准和歧视进行了评估，并比较癌症幸存者和无癌participators. Results-Cancer幸存者有较高的PCE预测风险，在26.1%，相比，23.1%的无癌参与者。癌症幸存者中有110起ASCVD事件，无癌症参与者中有332起ASCVD事件。PCE高估ASCVD风险的癌症幸存者和无癌参与者分别为45.6%和47.4%，在这两个群体的歧视差（C-统计癌症幸存者= 0.623;无癌参与者，C= 0.671）。PCEs在癌症幸存者和无癌受试者中的表现相似。对癌症幸存者的影响我们的研究结果表明，可能不需要针对成人癌症幸存者的ASCVD风险预测工具。
BackgroundCancer survivors may have elevated atherosclerotic cardiovascular disease (ASCVD) risk. Therefore, we tested how accurately the American College of Cardiology/American Heart Association 2013 pooled cohort equations (PCEs) predict 10-year ASCVD risk in cancer survivors.ObjectivesTo estimate the calibration and discrimination of the PCEs in cancer survivors compared to non-cancer participants in the Atherosclerosis Risk in Communities (ARIC) study.MethodsWe evaluated the PCEs’ performance among 1244 cancer survivors and 3849 cancer-free participants who were free of ASCVD at the start of follow-up. Each cancer survivor was incidence-density matched with up to five controls by age, race, sex, and study center. Follow-up began at the first study visit at least 1 year after the diagnosis date of the cancer survivor and finished at the ASCVD event, death, or end of follow-up. Calibration and discrimination were assessed and compared between cancer survivors and cancer-free participants.ResultsCancer survivors had higher PCE-predicted risk, at 26.1%, compared with 23.1% for cancer-free participants. There were 110 ASCVD events in cancer survivors and 332 ASCVD events in cancer-free participants. The PCEs overestimated ASCVD risk in cancer survivors and cancer-free participants by 45.6% and 47.4%, respectively, with poor discrimination in both groups (C-statistic for cancer survivors = 0.623; for cancer-free participants,C= 0.671).ConclusionsThe PCEs overestimated ASCVD risk in all participants. The performance of the PCEs was similar in cancer survivors and cancer-free participants.Implications for Cancer SurvivorsOur findings suggest that ASCVD risk prediction tools tailored to survivors of adult cancers may not be needed.
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