Long‐Term Cardiovascular Risk After Radiotherapy in Women With Breast Cancer
| Autor: | Cheng-Cheng Ji, Li-Juan Liu, Xiao-Ying Nie, Hao Yao, Xu-Miao Chen, Xiao-Xiong Lin, Yun-Jiu Cheng, Su-Hua Wu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Time Factors cardiovascular disease risk factors Heart disease Epidemiology medicine.medical_treatment cardiotoxicity cardiovascular complications Breast Neoplasms 030204 cardiovascular system & hematology Global Health 03 medical and health sciences 0302 clinical medicine Breast cancer Risk Factors cardiovascular disease Internal medicine medicine Humans Women Radiation Injuries Systematic Review and Meta‐Analysis Cardiotoxicity Framingham Risk Score cardiovascular disease prevention business.industry Incidence medicine.disease Survival Rate Primary Prevention Radiation therapy Cardiovascular Diseases 030220 oncology & carcinogenesis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| DOI: | 10.1161/jaha.117.005633 |
| Popis: | Background Radiotherapy for breast cancer often involves some incidental exposure of the heart to ionizing radiation. The effect of this exposure on the subsequent risk of heart disease is uncertain. We performed a meta‐analysis to investigate the link between radiotherapy and long‐term cardiovascular morbidity and mortality in patients with breast cancer. Methods and Results We performed a literature search using MEDLINE (January 1966 to January 2015) and EMBASE (January 1980 to January 2015) with no restrictions. Studies that reported relative risk ( RR ) estimates with 95% CI s for the associations of interest were included. Pooled effect estimates were obtained by using random‐effects meta‐analysis. Thirty‐nine studies involving 1 191 371 participants were identified. Patients who received left‐sided radiotherapy, as compared with those receiving right‐sided radiotherapy, experienced increased risks of developing coronary heart disease ( RR 1.29, 95% CI 1.13‐1.48), cardiac death ( RR 1.22, 95% CI 1.08‐1.37) and death from any cause ( RR 1.05, 95% CI 1.01‐1.10). In a comparison of patients with radiotherapy and without radiotherapy, the RR s were 1.30 (95% CI 1.13‐1.49) for coronary heart disease and 1.38 (95% CI 1.18‐1.62) for cardiac mortality. Radiotherapy for breast cancer was associated with an absolute risk increase of 76.4 (95% CI 36.8‐130.5) cases of coronary heart disease and 125.5 (95% CI 98.8‐157.9) cases of cardiac death per 100 000 person‐years. The risk started to increase within the first decade for coronary heart disease and from the second decade for cardiac mortality. Conclusions Exposure of the heart to ionizing radiation during radiotherapy for breast cancer increases the subsequent risk of coronary heart disease and cardiac mortality. |
| Databáze: | OpenAIRE |
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