Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer
Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer
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DOI：
10.1056/nejmoa1209825
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发表时间：
2013-03-14
影响因子：
158.5
通讯作者：
Hall, Per
中科院分区：
文献类型：
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作者：
Darby, Sarah C.;Ewertz, Marianne;Hall, Per
乳腺癌的放射治疗通常涉及心脏偶然暴露于电离辐射。这种暴露对随后缺血性心脏病风险的影响尚不确定。方法我们进行了一项基于人群的主要冠状动脉事件病例对照研究（即，心肌梗死、冠状动脉血运重建或缺血性心脏病死亡）;该研究包括963名患有主要冠状动脉事件的妇女和1205名对照。从医院记录中获得个体患者信息。对于每名妇女，平均辐射剂量的整个心脏和左冠状动脉前降支估计从她的放疗chart. TSTThe整体平均的平均剂量为4.9戈伊（范围，0.03至27.72）。主要冠状动脉事件的发生率随着心脏平均剂量的增加而线性增加，每格雷增加7.4%（95%置信区间，2.9至14.5; P
BACKGROUNDRadiotherapy for breast cancer often involves some incidental exposure of the heart to ionizing radiation. The effect of this exposure on the subsequent risk of ischemic heart disease is uncertain.METHODSWe conducted a population-based case-control study of major coronary events (i.e., myocardial infarction, coronary revascularization, or death from ischemic heart disease) in 2168 women who underwent radiotherapy for breast cancer between 1958 and 2001 in Sweden and Denmark; the study included 963 women with major coronary events and 1205 controls. Individual patient information was obtained from hospital records. For each woman, the mean radiation doses to the whole heart and to the left anterior descending coronary artery were estimated from her radiotherapy chart.RESULTSThe overall average of the mean doses to the whole heart was 4.9 Gy (range, 0.03 to 27.72). Rates of major coronary events increased linearly with the mean dose to the heart by 7.4% per gray (95% confidence interval, 2.9 to 14.5; P