Objective: To evaluate the association between digestive tract cancer and anatomical severity of coronary artery disease. Methods: This study enrolled 142 patients with digestive tract cancer who underwent coronary angiography in the Department of Cardiology of the First Medical Center of Chinese PLA General Hospital from 2009 to 2020 as the cancer group. The patients in cancer group were matched with 426 non-cancer patients who underwent coronary angiography at our hospital during the same period in a 1∶3 ratio based on gender and age. All enrolled patients had no previous history of percutaneous coronary intervention or coronary artery bypass grafting surgery. The severity of coronary artery disease was documented and assessed using the SYNTAX score based on angiogram. High SYNTAX score (SXhigh) was defined as SYNTAX score≥22 (upper quartile), while low SYNTAX score (SXlow) was SYNTAX score<22. High NLR (NLRhigh) was NLR≥2.287 (median), while low NLR (NLRlow) was NLR<2.287. The association between digestive tract cancer and severity of coronary artery disease was analyzed using logistic regression analysis. Results: This study included a total of 568 patients, with a mean age of (66.6±8.7) years. Among them, 430 patients (75.7%) were male. The cancer group consisted of 142 patients with digestive tract cancers, with a mean age of (66.5±8.4) years. The non-cancer group consisted of 426 patients, with a mean age of (66.7±8.8) years. The proportion of SXhigh in patients with digestive tract cancers (33.1%, 47 patients) was higher than that in non-cancer patients (23.9%, 102 patients) (P=0.032). Compared to non-cancer patients, SXhigh in patients with digestive tract cancers was higher (OR: 1.614, 95%CI: 1.051-2.481, P=0.029). Subgroup analysis stratified by NLR levels revealed that in the NLRhigh group, patients with digestive tract cancers exhibited a higher severity of coronary artery disease compared to non-cancer patients, with an OR of 1.948 (95%CI: 1.005-3.779, P=0.048). In the NLRlow group, there was no significant relationship between digestive tract cancers and the severity of coronary artery disease, with an OR of 1.277 (95%CI: 0.586-2.781, P=0.538). Conclusions: Digestive tract cancer is associated with the severity of coronary artery disease, and patients with digestive tract cancers have a higher risk of severe coronary artery disease than non-cancer patients. Additionally, there is an association between digestive tract cancers and the severity of coronary artery disease under conditions of high levels of inflammation.
目的： 探讨消化道肿瘤与冠状动脉疾病严重程度的相关性。 方法： 回顾性选取2009—2020年于解放军总医院第一医学中心心内科接受冠状动脉造影的患者为研究对象，共142例（肿瘤组），根据肿瘤组患者性别、年龄为匹配因素，按照1∶3比例匹配在同时期于本院行冠状动脉造影的非肿瘤患者共426例为非肿瘤组，所有纳入患者既往无冠状动脉支架植入术及冠状动脉旁路移植术病史。根据造影结果进行SYNTAX评分评定冠状动脉疾病的严重程度。以所有纳入患者的SYNTAX评分的上四分位数（22分）为截值点，SYNTAX评分≥22分为高SYNTAX评分（SXhigh），SYNTAX评分<22分为低SYNTAX评分（SXlow）。以所有纳入患者的中性粒细胞与淋巴细胞比值（NLR）的中位数（2.287）为截值点，NLR≥2.287为高NLR（NLRhigh），NLR<2.287为低NLR（NLRlow）。采用多因素logistic回归模型分析消化道肿瘤与冠状动脉疾病严重程度的相关性。 结果： 本研究共纳入研究对象568例，年龄为（66.6±8.7）岁，男430例（75.7%）。142例消化道肿瘤组年龄为（66.5±8.4）岁，426例非肿瘤组年龄为（66.7±8.8）岁。消化道肿瘤患者中SXhigh比例（33.1%，47例）高于非肿瘤患者（23.9%，102例）（P=0.032）。与非肿瘤患者相比，消化道肿瘤患者SXhigh的OR值（95%CI）为1.614（1.051~2.481）（P=0.029）。根据NLR水平分层进行亚组分析结果显示，在NLRhigh组，与非肿瘤患者相比，消化道肿瘤患者冠状动脉病变严重程度更高，OR值（95%CI）为1.948（1.005~3.779）（P=0.048）；在NLRlow组，消化道肿瘤与冠状动脉病变严重程度无相关性，OR值（95%CI）为1.277（0.586~2.781）（P=0.538）。 结论： 消化道肿瘤与冠状动脉疾病严重程度相关，消化道肿瘤患者严重冠状动脉疾病的风险高于非肿瘤患者；在高炎症水平下消化道肿瘤与冠状动脉病变严重程度具有相关性。.