Background/Objectives: Cancer survivors increasingly face cardiovascular disease (CVD), with diabetes as a major risk factor. This study investigates the relationship between adherence to antidiabetic medications and cardiovascular (CV) outcomes in cancer patients. Methods: Using data from the Korean National Health Insurance Service—National Sample Cohort, we assessed the clinical outcomes of adult cancer patients prescribed antidiabetic medications. The study population was categorized based on medication adherence, as determined by the medication possession ratio (MPR): good (MPR ≥ 0.8), moderate (0.5 ≤ MPR < 0.8), and poor (MPR < 0.5) adherence. The primary outcomes included overall and CV mortality, with secondary outcomes encompassing hospitalization for major CVDs and healthcare costs. Results: Among the 7928 cancer patients with diabetes, 59.7% were nonadherent (22.1% with moderate and 37.6% with poor adherence). Over a median follow-up of 5.7 years, 1462 deaths and 2897 CV events were confirmed. Multivariable adjusted analyses showed a 1.70-fold and 2.11-fold higher risk of overall mortality for the moderate and poor adherence groups, respectively, compared to the good adherence group. For CV mortality, moderate adherence was associated with a 1.51-fold higher risk, and poor adherence with a 2.10-fold higher risk. The risk for new-onset CV events increased by 1.32-fold in the moderate adherence group and 1.44-fold in the poor adherence group. The good adherence group also showed significantly lower total healthcare costs compared to the nonadherence group. Conclusions: The present study underscores the importance of adherence to antidiabetic medications in cancer patients, revealing significant associations with decreased mortality, CV events, and healthcare costs.
背景/目的：癌症幸存者日益面临心血管疾病风险，其中糖尿病是主要危险因素。本研究探讨癌症患者抗糖尿病药物依从性与心血管结局之间的关系。方法：基于韩国国民健康保险服务-国家样本队列数据，我们评估了接受抗糖尿病药物治疗的成年癌症患者的临床结局。研究人群根据药物持有率（MPR）确定的用药依从性分为三组：良好依从性（MPR ≥ 0.8）、中等依从性（0.5 ≤ MPR < 0.8）和不良依从性（MPR < 0.5）。主要结局指标包括全因死亡率和心血管死亡率，次要结局涵盖主要心血管疾病住院事件及医疗费用。结果：在7928名合并糖尿病的癌症患者中，59.7%存在用药不依从现象（中等依从性22.1%，不良依从性37.6%）。中位随访5.7年期间，共记录1462例死亡和2897例心血管事件。多变量调整分析显示，与良好依从组相比，中等依从组的全因死亡风险增加1.70倍，不良依从组增加2.11倍。心血管死亡率方面，中等依从组风险升高1.51倍，不良依从组升高2.10倍。新发心血管事件风险在中等依从组增加1.32倍，在不良依从组增加1.44倍。良好依从组的总医疗费用显著低于不依从组。结论：本研究强调癌症患者坚持抗糖尿病药物治疗的重要性，揭示其与降低死亡率、减少心血管事件及控制医疗成本之间存在显著关联。
肿瘤(癌症)患者之家