Prognosis of Cancer Patients with Aortic Stenosis Under Optimal Cancer Therapies and Conservative Cardiac Treatments
| Autor: | Sumika Ishigaki, Nobuaki Sato, Tomomi Fujita, Chika Sekine, Tohru Minamino, Kazuyuki Ozaki, Chika Yumoto, Yuji Okura, Mitsue Hashitate, Tsugumi Takayama, Satoko Sakakibara |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry Cancer General Medicine 030204 cardiovascular system & hematology medicine.disease Comorbidity 03 medical and health sciences Stenosis 0302 clinical medicine Aortic valve replacement Internal medicine Heart failure medicine Cardiology 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Stroke Survival analysis Dyslipidemia |
| Zdroj: | International Heart Journal. 59:750-758 |
| ISSN: | 1349-3299 1349-2365 2005-2014 |
| DOI: | 10.1536/ihj.17-320 |
| Popis: | Aortic stenosis (AS) is a life-threatening comorbidity of cancer patients. Aortic valve replacement (AVR) should be considered for some cancer patients, but neither the characteristics nor prognosis under conservative therapy is well known.We searched our echocardiography log (years 2005-2014) for cancer patients with AS, and 92 patients (54% female) were included in the study. To compare the survival curves, 470 control patients without AS were selected from our cancer registry.Mean age (± SD) was 77.6 ± 6.7 years for males and 81.6 ± 6.3 years for females. Mean aortic valve area (AVA) was 1.0 ± 0.3 cm2. Stomach, blood, and urinary bladder cancers were the major sites of current cancer. During the 5-year follow-up period, 44 patients with AS (48%) died; 26 (59%) due to cancer progression, 10 (23%) heart failure, and 4 (9%) stroke. Heart-failure death was significantly higher for patients with AS than for control patients (P < 0.001). Kaplan-Meier survival estimates were worse for stage I or II patients with AVA < 0.75 cm2 than for control patients (P = 0.016). Older age, advanced stages, absence of dyslipidemia, recent syncope, and chronic heart failure or AVA < 0.75 cm2 were significantly and independently associated with poor survival.Although the majority of cancer patients with AS died of cancer, a quarter died of heart failure. Careful follow-up is needed because cancer patients at earlier stages with symptomatic AS or AVA < 0.75 cm2 should be considered for AVR. |
| Databáze: | OpenAIRE |
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