| Objectives Accumulating evidence has shown that the incidence of cardiovascular and cerebrovascular events(CVE)is significantly increased in cancer populations,this study aimed to investigate the incidence and risk factors of CVE in cancer populations.Methods Totally 3 983 participants firstly diagnosed cancer during physical examination from June 2006 to December 2015.Interesting event was defined as CVE and the competing event was defined as all-cause mortality happened before CVE.In considering the competition risk,the cumulative incidence function(CIF)was used to estimate cumulative incidence of CVE and compared by Gray test analysis.Multivariate Fine-Gray regression model was used to analyze the risk factors of CVE.The risk factors selected by Fine-Gray analysis were grouped according to the number of risk factors and again used Fine-Gray to analyze the influence of risk factors on CVE.Risk factors were age?60 years,hypertension,smoking,body mass index(BMI)?24kg/m~2.Risk factors group as follows:group 0 had no risk factors,group 1 had any risk factors,group 2 had any two risk factors,group 3 had any three risk factors,and group 4 had four risk factors.Results There were 95 cases of CVE occurred during the follow up of 3.17±2.86 years.The mean follow-up time of cerebral infarction,myocardial infarction and cerebral hemorrhage were(3.20±2.88)years,(2.93±2.45)years,and(3.24±2.90)years respectively.The CIF in total CVE,cerebral infarction,myocardial infarction,cerebral hemorrhage were3.60%(3 983/95),2.48%(3 983/67),0.53%(3 983/21),and 0.29%(3 983/12)respectively.Results of single risk factor analysis showed that the CIF of CVE at age?60 years,hypertension,body mass index(BMI)?24kg/m~2 and smoking were 3.97%(2 307/67),5.59%(1 440/53),4.22%(2 266/65),and 5.46%(953/37)respectively.After Gray test,the difference was statistically significant between group(P<0.05).The multivariate Fine-Gray regression model analysis showed that the risk of total events and cerebral infarction in participants at age?60 years old were 1.98 and 2.28 times of those who at age?60 years old.Participants with hypertension were 1.75 and 1.86 times of those who without hypertension.Participants with smoking were 1.75 and 1.95 times of those who without smoking.Participants with BMI?24kg/m~2 were 2.24 and 1.94 times of those who with BMI?24kg/m~2(P<0.05).After adjusted for confound factors,compared with group 0,HR with 95%confidence interval(CI)of total CVE in group 1,2,3,and 4 were1.20(0.40~3.63),3.03(1.05~8.71),3.41(1.11~10.48)and 6.95(1.95~24.77)respectively,the HR with 95%CI of cerebral infarction in group 1,2,3,and 4 were 1.20(0.40~3.59),2.97(1.04~8.51),3.31(1.08~10.12)and 6.81(1.91~24.31)respectively.Except the group of 1,group of 2,3,and 4 were statistically significant(P<0.05).Conclusions In Kailuan Study,the incidence of CVE in cancer populations was 3.60%,age?60 years old,smoking,hypertension and BMI?24kg/m~2 are risk factors for CVE,the risk of CVE increased with the increasing of risk factors.Figure 4;Table 6;Reference 43?... |
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