肿瘤预防与治疗2025，Vol.38Issue(11)：953-959,7.DOI:10.3969/j.issn.1674-0904.2025.11.002
冠心病合并恶性肿瘤患者全因死亡风险及危险因素分析
All-Cause Mortality and Risk Factors in Patients with Coronary Artery Disease and Malignant Tumors
摘要
Abstract
Objective:To investigate the risk of all-cause mortality and its associated factors in patients with both coro-nary artery disease(CAD)and malignant tumors.The findings will inform risk stratification and the development of compre-hensive management strategies for these patients.Methods:A retrospective review was conducted of medical records from our hospital between November 2014 and December 2023.Patients whose discharge diagnoses included both CAD(ICD-10:I25.103)and a malignant tumor(ICD-10:C00-C97)were enrolled as the study subjects,and a database was estab-lished.Baseline clinical data were collected,and patients were followed up for survival.A multivariate Cox proportional hazards regression model was then employed to identify inde-pendent risk factors for all-cause mortality in patients with both CAD and malignant tumors.Results:The median follow-up time for 107 patients was 58.19(32.40,74.51)months,with 14 cases lost to follow-up.During the follow-up period,62 cases(57.94％)died from all causes,including 25 cases(23.37％)from cardio vascular diseases and 37 cases(34.57％)from tumors.Univariate analysis revealed statistically significant differences(P＜0.05)between the deceased and survivor groups.Specifically,the deceased group had a significantly higher age,composition of diabetes and atrial fibrillation,as well as higher levels of admission heart rate,creatinine,fibrinogen,and B-type natriuretic peptide.In contrast,they had signifi-cantly lower body mass index,admission diastolic blood pressure,platelet count,albumin(ALB),troponin T levels,and a lower proportion receiving chemotherapy.Multivariate Cox regression analysis identified elevated heart rate upon admission as an independent risk factor for all-cause mortality(HR=1.022,95％CI:1.005～1.039,P=0.009).Conversely,high-er albumin levels(HR=0.927,95％CI:0.882～0.974,P=0.003)and the administration of chemotherapy(HR=0.549,95％CI:0.312～0.967,P=0.038)were independent protective factors.Conclusion:Patients with comorbid CAD and malignant tumors face a substantially elevated mortality rate,with lymphoma and lung cancer being the most preva-lent malignancies.This study identifies an elevated admission heart rate as an independent risk factor for all-cause mortality,while higher albumin levels and chemotherapy are protective.Clinical attention should be given to comorbid patients with the aforementioned risk factors.关键词
肿瘤心脏病学/冠心病/恶性肿瘤/心血管疾病死亡率/全因死亡率Key words
Cardio-oncology/Coronary artery disease/Malignant tumors/Cardiovascular mortality/All-cause mortality分类
医药卫生引用本文复制引用
李谷,张婧,褚婷婷..冠心病合并恶性肿瘤患者全因死亡风险及危险因素分析[J].肿瘤预防与治疗,2025,38(11):953-959,7.基金项目
山西省基础研究计划项目(编号:202203021222421) This study was supported by grants from Science and Technology Department of Shanxi Province(No.202203021222421). （编号:202203021222421）
