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성균관대학교 의과대학

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JACC-Cardiooncol., Volume 6, Issue 6, December 2024, P 879-889 | https://doi.org/10.1016/j.jaccao.2024.09.013 Changes in Physical Activity and Cardiovascular Disease Risk in Cancer Survivors: A Nationwide Cohort Study

Wonyoung Jung MD, PhD, MSc ^a,b∗, In Young Cho MD, MPH ^c∗, Jinhyung Jung PhD ^d, Mi Hee Cho MD ^e, Hye Yeon Koo MD ^f, Yong-Moon Mark Park MD, PhD ^g,h, Kyungdo Han PhDⁱ, Dong Wook Shin MD, DrPH, MBA ^j,k

^aDepartment of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
^bDepartment of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
^cDepartment of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
^dDepartment of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
^eSamsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
^fDepartment of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
^gDepartment of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
^hWinthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
ⁱDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
^jDepartment of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
^kCenter for Trend Sensing-Risk Modeling, Institute of Quality of Life in Cancer, Samsung Medical Center, Seoul, Republic of Korea

^∗Drs Jung and Cho are joint first authors.
Corresponding authors: Kyungdo Han, Dong Wook Shin

Abstract

Background
Cancer survivors face an elevated risk of cardiovascular disease, with physical inactivity after cancer treatment potentially worsening this risk.

Objectives
The aim of this study was to investigate the association between physical activity before and after a cancer diagnosis and the risk for heart disease.

Methods
A nationwide cohort of 269,943 cancer survivors (mean age 56.3, 45.7% men) was evaluated for physical activity adherence 2 years before and after diagnosis. The primary outcomes were the incidence of myocardial infarction (MI), heart failure (HF), and atrial fibrillation. Subdistribution HRs (sHRs) and 95% CIs were calculated using Gray’s method, accounting for death as a competing risk.

Results
Over a follow-up period of 1,111,329.28 person-years, compared with those who remained inactive, persistent physical activity was associated with a 20% reduction in MI risk (sHR: 0.80; 95% CI: 0.70-0.91) and a 16% reduction risk in HF risk (sHR: 0.84; 95% CI: 0.78-0.90). Initiating physical activity after a cancer diagnosis was linked to an 11% lower risk for MI (sHR: 0.89; 95% CI: 0.79-0.99) and a 13% lower risk for HF (sHR: 0.87; 95% CI: 0.82-0.93). Being active only before diagnosis was associated with a 20% lower risk for MI (sHR: 0.80; 95% CI: 0.71-0.91) and a 6% lower risk for HF (sHR: 0.94; 95% CI: 0.88-1.00). No association was observed between physical activity and atrial fibrillation risk. Associations varied by primary cancer site.

Conclusions
These findings underscore the importance of maintaining physical activity for cardiovascular health in cancer survivors and suggest that physical activity before a diagnosis may offer enduring protection against ischemic heart disease and cardiac dysfunction.

논문정보

형식Research article
게재일2024년 12월 (BRIC 등록일 2025-01-10)
연구진국내(교신)+국외 연구진
분야 의약학 > 응용의학

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