Background/Objectives: Among survivors of cancer diagnosed in childhood, adolescence, or young adulthood (C-AYAs), cardiotoxic therapies combined with acquired cardiovascular risk factors (CVRFs) increase the risk for cardiovascular events. To our knowledge, no prior analysis has examined CVRFs among C-AYAs < 20 years old or compared CVRFs among younger and older C-AYAs.Methods: In this single-center study, individuals diagnosed with cancer at ≤39 years, treated with anthracycline-based chemotherapy (2010–2023), and with a post-treatment lipid panel and ≥2 post-treatment ambulatory blood pressure measurements were included. The CVRF prevalence was assessed among C-AYAs < 20 and ≥20 years old, using age-appropriate AAP and ACC/AHA guidelines. These prevalences were compared with the ICD-9/10 code prevalence. The prescription of medications with antihypertensive effects (MAHEs) and lipid-lowering therapy was assessed.Results:Among 276 C-AYAs, the median age was 28.1 years (IQR 18.1–38.3) at dyslipidemia screening and 29.3 (IQR 20.0–38.7) at hypertension screening. Dyslipidemia was present in 52.9% (146/276) and hypertension in 56.2% (155/276) of C-AYAs. C-AYAs < 20 years old had a high prevalence of dyslipidemia, 51.7% (45/87), and hypertension, 31.9% (29/91). CVRFs were frequently underdiagnosed, particularly dyslipidemia, among C-AYAs < 20 years old, with only 12.6% (11/87) having a diagnosis via the ICD code. C-AYAs < 20 years old with diagnoses of dyslipidemia and hypertension were significantly less likely to receive lipid-lowering therapy (2.2% vs. 14.9%) and trended toward less MAHEs (13.8% vs. 31.0%) compared to C-AYAs ≥ 20.Conclusions: Among C-AYAs treated with anthracyclines, dyslipidemia and hypertension were highly prevalent even at a young age (<20 years). Younger survivors with dyslipidemia and hypertension were less frequently prescribed lipid-lowering therapy or MAHEs.
背景/目的：在儿童、青少年或青年期（C-AYAs）确诊的癌症幸存者中，心脏毒性疗法与获得性心血管危险因素（CVRFs）共同增加了心血管事件的风险。据我们所知，此前尚无研究专门分析20岁以下C-AYAs的CVRFs情况，亦未对年轻与年长C-AYAs的CVRFs进行过比较。 方法：本单中心研究纳入了39岁前确诊癌症、接受过蒽环类化疗（2010–2023年）、且治疗后完成血脂检测及至少2次动态血压监测的患者。采用符合年龄段的美国儿科学会（AAP）和美国心脏病学会/美国心脏协会（ACC/AHA）指南，评估20岁以下与20岁及以上C-AYAs的CVRFs患病率，并与ICD-9/10诊断编码记录的患病率进行比较。同时评估了具有降压作用的药物（MAHEs）及降脂治疗的应用情况。 结果：在276名C-AYAs中，血脂异常筛查时的中位年龄为28.1岁（四分位距18.1–38.3），高血压筛查时为29.3岁（四分位距20.0–38.7）。总体C-AYAs中，52.9%（146/276）存在血脂异常，56.2%（155/276）存在高血压。20岁以下C-AYAs的血脂异常患病率高达51.7%（45/87），高血压患病率为31.9%（29/91）。CVRFs在20岁以下C-AYAs中常被漏诊，尤其是血脂异常，仅12.6%（11/87）通过ICD编码获得诊断。与20岁及以上者相比，确诊血脂异常和高血压的20岁以下C-AYAs接受降脂治疗的比例显著更低（2.2% vs. 14.9%），使用MAHEs的比例也呈较低趋势（13.8% vs. 31.0%）。 结论：在接受蒽环类药物治疗的C-AYAs中，血脂异常和高血压患病率极高，即使在年轻（<20岁）群体中也是如此。患有血脂异常和高血压的年轻幸存者接受降脂治疗或MAHEs的比例更低。
肿瘤(癌症)患者之家