淋巴瘤合并非急性冠状动脉综合征冠心病患者的长期预后分析:一项单中心回顾性研究

Long-term outcomes in patients with non-acute coronary syndrome coronary artery disease complicated with lymphoma:A single center retrospective study

目的分析淋巴瘤并发非急性冠状动脉综合征冠状动脉粥样硬化性心脏病(冠心病)患者的临床特点和随访结果。方法检索2013年1月至2017年8月在中国医学科学院北京协和医学院阜外医院住院患者数据库中出院诊断包括"冠心病"和"淋巴瘤"、"肉瘤"或"癌"的所有患者,分为淋巴瘤组和非淋巴瘤组,登记治疗数据并电话随访。比较两组间人口学和共患病的基线特征、冠心病治疗情况以及临床终点事件发生情况的差异。结果最终纳入并完成随访121例恶性肿瘤并发冠心病患者,淋巴瘤组和非淋巴瘤组分别为59例和62例,淋巴瘤患者占同期冠心病介入治疗患者的0.09%。以患者出院时为基线,淋巴瘤组患者与非淋巴瘤组患者比较,年龄更年轻[(60.5±12.3)岁vs.(66.6±9.7)岁,P=0.003],肿瘤确诊后生存期更长[(12.1±7.75)年vs.(9.24±7.06)年,P=0.035],先患冠心病的比例明显偏低[27.1%vs.43.5%,P=0.044],差异均有统计学意义。随访期间两组各有14例死亡,两组病死率比较,差异无统计学意义(P>0.05)。淋巴瘤组患者严重出血事件的发生率显著低于非淋巴瘤组,差异有统计学意义(0%vs.8.1%,P=0.033)。结论淋巴瘤患者与非淋巴瘤患者相比,冠心病发病年龄更轻,且更多见于肿瘤发生以后,严重出血事件更少,在确诊肿瘤后的生存期更长。

Objectives To analyze the characteristics and outcomes in patients with non-acute coronary syndrome coronary artery disease(CAD)complicated with lymphoma.Methods Patients with discharge diagnosis of"coronary heart disease"and"lymphoma","sarcoma"or cancer"in the hospitalized database of Fuwai Hospital,Chinese Academy of Medical Sciences from January 2013 to August 2017 were retrospectively searched.The patients were divided into lymphoma and non-lymphoma group.Baseline demographics,comorbidities characteristics and endpoint events between two groups were compared.Results There were totally 121 eligible patients enrolled,59 in lymphoma group and 62 in the other one.The patients were significantly younger in lymphoma group than that in non-lymphoma group[(60.5±12.3)years vs.(66.6±9.7)years,P=0.003];longer survival duration after tumor diagnosis[(12.1±7.75)years vs.(9.24±7.06)years,P=0.035];lower proportion of pre-existing CAD[27.1%vs.43.5%,P=0.044];and lower severe bleeding events(0%vs.8.1%,P=0.033).Conclusions Compared with patients with non-lymphoma,patients with lymphoma were younger at the onset of CAD,CAD were more common after the tumor onset,severe bleeding events were less and have longer survival duration after tumor diagnosis.