Increased risk of coronary heart disease and stroke in lung cancer survivors: A Korean nationwide study of 20,458 patients

Autor: Dong Wook Shin, Jong Ho Cho, Su Min Jeong, Dong Woog Yoon, Sang Hyun Park, Jeong Hoon Yang, Kyungdo Han
Rok vydání: 2019
Předmět:
Adult
Male
0301 basic medicine
Pulmonary and Respiratory Medicine
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
Population
Coronary Disease
Comorbidity
Risk Assessment
Young Adult
03 medical and health sciences
0302 clinical medicine
Cancer Survivors
Risk Factors
Internal medicine
Republic of Korea
Humans
Medicine
Public Health Surveillance
Myocardial infarction
Lung cancer
education
Stroke
Aged
Proportional Hazards Models
Aged
80 and over
Lung cancer surgery
education.field_of_study
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Middle Aged
respiratory system
medicine.disease
respiratory tract diseases
Patient Outcome Assessment
Radiation therapy
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Female
business
Follow-Up Studies
Zdroj: Lung Cancer. 136:115-121
ISSN: 0169-5002
Popis: Objectives With advances in lung cancer treatments, the number of lung cancer survivors has increased. As cardiovascular diseases (CVD) are some of the major causes of non-cancer deaths, CVD management is an integral part of cancer survivorship care. However, there is sparsity of data on cardiovascular risk in lung cancer survivors who underwent lung cancer surgery. We aimed to compare the incidence of CVD between lung cancer survivors and the general non-cancer population. Materials and methods Using the Korean National Health Insurance Service Database, we selected 20,458 patients who underwent surgery for lung cancer between 2007 and 2013. Study outcome variables were coronary heart disease (CHD), myocardial infarction (MI), ischemic stroke (IS), and death. Patients were followed until 2016. Results A total of 20,458 lung cancer patients undergoing lung cancer surgery were compared to 27,321 non-cancer control subjects. Lung cancer survivors showed a greater risk for all cardiovascular (CV) events (adjusted hazard ratio [aHR] = 1.27, 95% confidence interval [CI]: 1.19–1.36), CHD (aHR = 1.26, 95% CI: 1.16–1.36), and IS (aHR = 1.22, 95% CI: 1.07–1.39). Chemotherapy and radiotherapy were associated with an increased risk of CV events, CHD, and MI. Lung cancer survivors who were CV event-free for one year, and up to three years, were still at a higher risk for all CV events compared to the non-cancer control population. Conclusions Lung cancer survivors showed an increased risk of CHD and IS compared with the general non-cancer population. Therefore, paying careful attention to cardiovascular risk in lung cancer survivors is suggested, especially for those who receive chemotherapy and/or radiotherapy, in order to ensure both early and long-term survivorship.
Databáze: OpenAIRE
Externí odkaz: