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Int J Cardiol:血液系统恶性肿瘤患者急性冠状动脉综合征发病率、治疗和结局

2018-10-05 xing.T MedSci原创

由此可见,在这项针对患有活动性恶性血液病成人的大型现代研究中,ACS并不常见。

癌症和血管疾病是工业化国家的两个主要死因。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章。该研究旨在解决活动性血液系统恶性肿瘤患者急性冠状动脉综合征(ACS)的发生率、治疗和结局。

这项基于登记中心的回顾性队列研究纳入了2004年1月1日至2014年12月31日期间在罗切斯特梅奥诊所住院治疗的患有活动性白血病淋巴瘤的成人。ST段抬高型MI(STEMI)或非ST段抬高型MI(NSTEMI)的诊断是基于MI或心肌肌钙蛋白不升高的不稳定型心绞痛(UA)的第3次通用定义。该研究的主要结局指标包括住院期间和1年内的全因、心脏和非心源性死亡。

在5300名患有活动性血液系统恶性肿瘤的成年患者中,73名(1.4%)患者被诊断为ACS(78.1%为NSTEMI和13.7%为STEMI)。分别有17.5%和40%的NSTEMI和STEMI患者接受冠状动脉造影,经皮冠状动脉介入治疗的患者分别为5.3%和30%。虽然超过80%的患者接受了β-受体阻滞剂治疗,但只有一半的患者和少于50%的患者接受抗血小板、抗凝血和/或他汀类药物治疗。住院和1年死亡率分别为21.9%和58.9%,其中25%和15%是心脏病所致。阿司匹林、β-受体阻滞剂、他汀类药物和血管紧张素转换酶抑制剂/血管紧张素-II受体阻滞剂治疗与更好的死亡率结局相关。

由此可见,在这项针对患有活动性恶性血液病成人的大型现代研究中,ACS并不常见。

原始出处:

Jae YoonPark,et al.Acute coronary syndromes in patients with active hematologic malignancies – Incidence, management, and outcomes.International Journal of Cardiology.2018.https://doi.org/10.1016/j.ijcard.2018.10.008

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《2017年意大利共识指南:血液系统恶性肿瘤以及接受造血干细胞移植患者HBV再激活的筛查、监测、预防和预防性治疗的建议》摘译

HBV再激活与血液系统恶性肿瘤/造血干细胞移植(HSCT)患者的高发病率和病死率相关,但关于这个问题的证据是有限的。本指南将提供该类患者的HBV筛查、监测、预防、治疗和疫苗接种的建议。综合意大利不同医学领域学会在同期刊物发表的关于血液病患者和接受HSCT患者HBV 感染的系统文献综述(至2016 年12 月31日)总结出该指南。

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清髓性异体干细胞移植(HCT)后认知功能损害已得到公认,但是低强度异体或自体HCT后对认知功能的影响尚不清楚。JCO近期发表了一篇文章研究这一问题。

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