Prediabetes is associated with increased cardiac events in patients with cancer who are prescribed anthracyclines

作者：Iokfai Cheang, Xu Zhu, Jiayi Huang, Yi‐Kei Tse, Hang‐Long Li, Q W Ren, Mei‐Zhen Wu, Yap‐Hang Chan, Xin Xu, Hung‐Fat Tse, Ying X. Gue, Gregory Y.H. Lip, Xinli Li, Kai‐Hang Yiu · 发表于：Cancer · 年份：2024 · DOI：10.1002/cncr.35322 · 被引用次数：5 · 研究领域：Chemotherapy-induced cardiotoxicity and mitigation、Metabolism, Diabetes, and Cancer、Cardiovascular Function and Risk Factors

BACKGROUND: Prediabetes, which is a precedent of overt diabetes, is a known risk factor for adverse cardiovascular outcomes. Its impact on adverse cardiovascular outcomes in patients with cancer who are prescribed anthracycline-containing chemotherapy (ACT) is uncertain. The objective of this study was to evaluate the association of prediabetes with cardiovascular events in patients with cancer who are prescribed ACT. METHODS: The authors identified patients with cancer who received ACT from 2000 to 2019 from Clinical Data Analysis Reporting System of Hong Kong. Patients were divided into diabetes, prediabetes, and normoglycemia groups based on their baseline glycemic profile. The Primary outcome, a major adverse cardiovascular event (MACE), was the composite event of hospitalization for heart failure and cardiovascular death. RESULTS: Among 12,649 patients at baseline, 3997 had prediabetes, and 5622 had diabetes. Over median follow-up of 8.7 years, the incidence of MACE was 211 (7.0%) in the normoglycemia group, 358 (9.0%) in the prediabetes group, and 728 (12.9%) in the diabetes group. Compared with normoglycemia, prediabetes (adjusted hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.01-1.43) and diabetes (adjusted HR, 1.46; 95% CI, 1.24-1.70) were associated with an increased risk of MACE. In the prediabetes group, 475 patients (18%) progressed to overt diabetes and exhibited a greater risk of MACE (adjusted HR, 1.76; 95% CI, 1.31-2.36) compared with patients who r...