| アブストラクト | AIMS: Cancer survivors are at increased cardiovascular risk due to shared risk factors and treatment-related toxicity. The recently proposed cardiovascular-kidney-metabolic (CKM) syndrome framework provides a novel approach for cardiometabolic risk stratification, but its prognostic value in cancer patients remains unclear. In this study, we aimed to evaluate the association between CKM stages and cardiovascular outcomes in cancer patients using a large-scale nationwide dataset. METHODS AND RESULTS: We conducted a retrospective cohort study of 76 111 cancer patients without prior CVD from the DeSC database (2014-2023). Participants were classified into CKM stages (0-3) at baseline, with Stage 4 defined as the composite outcome of myocardial infarction, heart failure, atrial fibrillation, stroke, or peripheral artery disease. Multivariable Cox proportional hazards models were used to assess the risk of progression to Stage 4. Over a median follow-up of 2.6 years, advancing CKM stages were associated with a graded increase in cardiovascular disease (CVD) risk. Compared to Stage 0-1 (reference), adjusted hazard ratios for Stage 4 were 1.23 (95% confidence interval: 1.13-1.33) for Stage 2 and 1.47 (1.36-1.60) for Stage 3. Sensitivity analyses confirmed consistent associations across different groups stratified by age, sex, chemotherapy history, and cancer types. Furthermore, sensitivity analyses using alternative risk prediction models or expanded CVD definitions yielded similar results. CONCLUSION: The CKM staging system effectively stratifies cardiovascular risk in cancer patients, with higher stages predicting significantly worse outcomes. These findings advocate for integrating CKM assessment into onco-cardiologic practice to guide early intervention and improve patient outcomes. |
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| 投稿者 | Ko, Toshiyuki; Suzuki, Yuta; Kaneko, Hidehiro; Okada, Akira; Jimba, Takahiro; Azegami, Tatsuhiko; Mizuno, Atsushi; Ejiri, Kentaro; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Hayashi, Kaori; Node, Koichi; Yasunaga, Hideo; Nangaku, Masaomi; Takeda, Norihiko |
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| 組織名 | Department of Cardiovascular Medicine, Graduate School of Medicine, The;University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.;Center for Outcomes Research and Economic Evaluation for Health, National;Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan.;Department of Advanced Cardiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku,;Tokyo 113-8655, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo;113-8655, Japan.;Division of Endocrinology, Metabolism, and Nephrology, Department of Internal;Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo;160-8582, Japan.;Department of Cardiology, Medical Quality Management Office, QI Center, St.;Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.;Department of Cardiovascular Medicine, Okayama University Graduate School of;Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku,;Okayama 700-8558, Japan.;Department of Cardiovascular Medicine, Saga University, 1 Honjo-machi, Saga City,;Saga 840-8502, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.;Division of Nephrology and Endocrinology, Graduate School of Medicine, The;University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. |
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