Aims The cardiac and vascular late sequelae in long-term survivors of childhood cancer (CVSS)-study aimed to quantify the prevalence of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) in German childhood cancer survivors (CCS). Methods and results In the CVSS-study (NCT02181049), 1002 CCS (age range 23-48 years) diagnosed with neoplasia prior to 15 years of age between 1980 and 1990 prospectively underwent a systematic, standardized clinical and laboratory cardiovascular screening, identical to the population-based Gutenberg Health Study (GHS) cohort. For 951 individuals, prevalences of CVRF and CVD were primarily compared to the GHS sample and to two further German population-based cohorts. Using log-binomial regression models, an increased risk for occurrence of arterial hypertension [relative risk (RR) 1.38, 95% confidence interval (95% CI 1.21-1.57)] and dyslipidaemia [RR 1.26 (95% CI 1.12-1.42)] was found. This indicates a premature occurrence compared to the general population of approximately 6 and 8 years, respectively [rate advancement period estimator, RAPhypertension 5.75 (95% CI 3.5-8.0) and RAPdyslipidaemia 8.16 (95% CI 4.4-11.9)]. Overall, no differences were observed for obesity and diabetes. Overt CVD was present in 4.5% (95% CI 3.0-6.6%) of CCS [RR 1.89 (95% CI 1.34-2.66), RAPCVD 7.9 (95% CI 4.1-11.7)], of which the most frequent entities were congestive heart failure and venous thromboembolism. Prevalences of CVRF and CVD increased with age without reaching a plateau over time. Conclusion This large CCS screening examination revealed consistently in comparison to three population samples a considerably increased risk for premature CVD. The findings in these young adult CCS indicate a high burden of cardiovascular morbidity and mortality in the long term. Clinicaltrials. gov-Nr NCT02181049.

中文翻译：

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儿童癌症幸存者的心血管危险因素和心血管疾病负担：来自德国 CVSS 研究的数据

目的 儿童癌症长期幸存者 (CVSS) 的心脏和血管晚期后遗症研究旨在量化德国儿童癌症幸存者 (CCS) 中心血管危险因素 (CVRF) 和心血管疾病 (CVD) 的患病率。方法和结果 在 CVSS 研究 (NCT02181049) 中，1980 年至 1990 年间在 15 岁之前诊断为肿瘤的 1002 名 CCS（年龄范围 23-48 岁）前瞻性地接受了系统、标准化的临床和实验室心血管筛查，与基于人群的古腾堡健康研究 (GHS) 队列。对于 951 个人，主要将 CVRF 和 CVD 的患病率与 GHS 样本和另外两个基于德国人群的队列进行比较。使用对数二项式回归模型，发生动脉高血压的风险增加 [相对风险 (RR) 1.38，发现了 95% 置信区间 (95% CI 1.21-1.57)] 和血脂异常 [RR 1.26 (95% CI 1.12-1.42)]。这表明与大约 6 岁和 8 岁的一般人群相比，早发性发生率分别为 [速率提前期估计值，RAPhypertension 5.75 (95% CI 3.5-8.0) 和 RAPdyslipidaemia 8.16 (95% CI 4.4-11.9)]。总体而言，肥胖和糖尿病没有观察到差异。4.5% (95% CI 3.0-6.6%) 的 CCS [RR 1.89 (95% CI 1.34-2.66)，RAPCVD 7.9 (95% CI 4.1-11.7)] 存在明显的 CVD，其中最常见的是充血性心力衰竭和静脉血栓栓塞。CVRF 和 CVD 的患病率随着年龄的增长而增加，但不会随着时间的推移达到平台期。结论 与三个人群样本相比，这项大型 CCS 筛查检查一致显示，过早发生 CVD 的风险显着增加。这些年轻成人 CCS 的研究结果表明，从长远来看，心血管发病率和死亡率的负担很高。临床试验。政府编号 NCT02181049。