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Doença Arterial Coronariana Anatômica Associada à Quimioterapia em Pacientes com Câncer de Pulmão Avaliada pelo Escore Angiográfico SYNTAX / Chemotherapy-Related Anatomical Coronary-Artery Disease in Lung Cancer Patients Evaluated by Coronary-Angiography SYNTAX Score
Yang, Qian; Chen, Yundai; Gao, Hai; Zhang, Jianzhong; Zhang, Juan; Zhang, Mingjie; Jing, Jing; Zhu, Pingjun; Zhou, Hao; Hu, Shunying.
  • Yang, Qian; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Chen, Yundai; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Gao, Hai; Beijing An Zhen Hospital. Department of Cardiology, Chaoyang-qu. Beijing. CN
  • Zhang, Jianzhong; Unimed Scientific Inc. Wuxi. CN
  • Zhang, Juan; Chinese PLA General Hospital. First Medical Center. Department of Oncology. Beijing. CN
  • Zhang, Mingjie; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Jing, Jing; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Zhu, Pingjun; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Zhou, Hao; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
  • Hu, Shunying; Chinese PLA General Hospital. First Medical Center. Department of Cardiology. Beijing. CN
Arq. bras. cardiol ; 114(6): 1004-1012, Jun., 2020. tab, graf
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131236
Responsible library: BR1.1
RESUMO
Resumo Fundamento A doença arterial coronariana (DAC) associada à quimioterapia está se tornando um tema emergente na prática clínica. Contudo, o mecanismo subjacente da quimioterapia associada à DAC permanence incerto. Objetivos O estudo investigou a associação entre a quimioterapia e as anomalias anatômicas ateroscleróticas das artérias coronárias dentre pacientes com cancer de pulmão. Métodos Foram incluídos pacientes submetidos à angiografia coronária (AGC), entre 2010 e 2017, com câncer de pulmão prévio. Os fatores de risco associados à DAC e os dados sobre o câncer de pulmão foram avaliados. Avaliamos as anomalias das artérias coronárias de acordo com o escore SYNTAX (SXescore) calculado à AGC. Na análise de regressão logística, o escore SYNTAX foi classificado como alto (SXescoreALTO) se ≥22. Os dados foram analisados através de estatística descritiva e análise de regressão. Resultados Ao todo, 94 pacientes foram incluídos no estudo. O SXescore foi mais alto no grupo com quimioterapia quando comparado com o grupo sem quimioterapia (25,25, IIQ [4,50-30,00] versus 16,50, IIQ [5,00-22,00]; p = 0,0195). A taxa do SXescoreALTO foi maior no grupo com quimioterapia do que no no grupo sem quimioterapia (58,33% versus 25,86; p = 0,0016). Tanto a análise de regressão logística univariada (OR 4,013; 95% IC1,655-9,731) quanto a multivariada (OR 5,868; 95% IC1,778-19,367) revelaram que a quimioterapia aumentou o risco de uma maior taxa do SXescoreALTO. A análise multivariada de regressão logística Stepwise mostrou que o risco para DAC anatômica mais grave aumenta com a quimioterapia como um todo em 5.323 vezes (95% IC 2,002-14,152), e com o regime à base de platina em 5,850 vezes (95% IC 2,027-16,879). Conclusões A quimioterapia está associada com a complexidade e gravidade anatômica da DAC, o que pode explicar, em parte, o maior risco de DAC associada à quimioterapia dentre pacientes com câncer de pulmão. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
ABSTRACT
Abstract Background Chemotherapy-related coronary artery disease (CAD) is becoming an emerging issue in clinic. However, the underlying mechanism of chemotherapy-related CAD remains unclear. Objective The study investigated the association between chemotherapy and atherosclerotic anatomical abnormalities of coronary arteries among lung cancer patients. Methods Patients undergoing coronary angiography (CAG) between 2010 and 2017, who previously had lung cancer, were examined. Risk factors associated with CAD and information about lung cancer were evaluated. We assessed coronary-artery abnormalities by SYNTAX score (SXscore) based on CAG. In logistic-regression analysis, we defined high SXscore (SXhigh) grade as positive if ≥22. Data were analyzed through descriptive statistics and regression analysis. Results A total of 94 patients were included in the study. The SXscore was higher in the chemotherapy group than in the non-chemotherapy group (25.25, IQR [4.50-30.00] vs. 16.50, IQR [ 5.00-22.00], p = 0.0195). The SXhigh rate was greater in the chemotherapy group than in the non-chemotherapy group (58.33% vs. 25.86; p = 0.0016). Both univariate (OR4.013; 95% CI1.655-9.731) and multivariate (OR5.868; 95% CI1.778-19.367) logistic-regression analysis revealed that chemotherapy increased the risk of greater SXhigh rates. Multivariate stepwise logistic-regression analysis showed the risk of more severe anatomical CAD is increased by chemotherapy as a whole by 5.323 times (95% CI 2.002-14.152), and by platinum-based regimens by 5.850 times (95% CI 2.027-16.879). Conclusions Chemotherapy is associated with anatomical complexity and severity of CAD, which might partly account for the higher risk of chemotherapy-related CAD among lung cancer patients. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Carotid Artery Diseases / Coronary Angiography / Coronary Vessels / Lung Neoplasms / Antineoplastic Agents Type of study: Risk factors Language: English / Portuguese Journal: Arq. bras. cardiol Year: 2020 Type: Article Institution/Affiliation country: Beijing An Zhen Hospital/CN / Chinese PLA General Hospital/CN / Unimed Scientific Inc/CN

Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Carotid Artery Diseases / Coronary Angiography / Coronary Vessels / Lung Neoplasms / Antineoplastic Agents Type of study: Risk factors Language: English / Portuguese Journal: Arq. bras. cardiol Year: 2020 Type: Article Institution/Affiliation country: Beijing An Zhen Hospital/CN / Chinese PLA General Hospital/CN / Unimed Scientific Inc/CN