As the aging population has progressed and oncology treatments have revolutionized, the clinical situation of cardiovascular disease complicating malignancy has become more common, and the field of cardio-oncology has gained much attention. When hematological malignancy is combined with coronary heart disease, the condition can be aggravated by pathological mechanisms such as imbalance of oxygen supply and bleeding coagulation abnormalities. However, the factors affecting the prognosis have rarely been reported.

To investigate the influencing factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

Data from the medical records of General Hospital of Southern Theater Command between January 2013 and December 2020 were retrieved to select patients whose diagnostic book homepage contained the keywords coronary heart disease or coronary atherosclerotic heart disease and hematological malignancy (leukemia or lymphoma or multiple myeloma) to establish a repository of patients with coronary heart disease combined with hematological malignancy. Patients' clinical data were collected and followed up for survival status, major adverse cardiovascular events (MACE) and the occurrence or absence and time of major bleeding events. They were divided into survival and death groups by survival status, and statistical analysis was performed for each indicator in the two groups. Multivariate Cox regression analysis was used to explore the risk factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

A total of 68 patients were finally included in the study, 52 died (76.47%) , the median survival time was 10.93 months, and the median follow-up time was 67.33 months. Compared with the survival group, patients in the death group were older, had faster heart rate at admission, lower body mass index, smaller body surface area, lower hemoglobin, albumin level, higher cystatin C level, higher proportion of elevated brain natriuretic peptide, and higher proportion of chemotherapy and stem cell transplantation (P<0.05) . Multivariate Cox regression analysis showed that elevated body mass index〔HR=0.841, 95%CI (0.761, 0.930) , P=0.001〕, receipt of chemotherapy〔HR=0.340, 95%CI (0.182, 0.637) , P=0.001〕, increased albumin level〔HR=0.934, 95%CI (0.889, 0.982) , P=0.008〕 were independent protective factors for death events. Elevated fibrinogen〔HR=1.635, 95%CI (1.291, 2.071) , P<0.001〕, and platelet count less than 100×10⁹/L〔HR=2.500, 95%CI (1.336, 4.678) , P=0.004〕 were independent risk factors for mortality.

Patients with coronary heart disease and hematological malignancies have poor prognosis, and the risk factors associated with all-cause mortality are elevated fibrinogen and platelet count less than 100×10⁹/L.

随着人口老龄化进展及肿瘤治疗手段的不断革新，心血管疾病与恶性肿瘤并发的临床情况越发常见，肿瘤心脏病学领域被广为关注。冠心病合并血液恶性肿瘤患者可因氧供耗失衡、出凝血异常等病理机制导致病情加重，但影响预后的因素鲜有报道。

探讨冠心病合并血液恶性肿瘤患者全因死亡的影响因素。

检索2013年1月至2020年12月南部战区总医院病案数据，选取首页诊断中包含冠心病或冠状动脉粥样硬化性心脏病和血液恶性肿瘤（白血病或淋巴瘤或多发性骨髓瘤）为关键词的患者，建立冠心病合并血液恶性肿瘤患者库。收集患者的临床资料、随访生存状态、主要心血管不良事件（MACE）及主要出血事件发生与否及发生时间。按生存状态分为生存组和死亡组，对两组的各项指标进行统计分析。采用多因素Cox回归分析探讨冠心病合并血液恶性肿瘤患者全因死亡的风险因素。

最终共纳入患者68例，52例死亡（76.47%），中位生存时间10.93个月，中位随访时间67.33个月。相较于生存组，死亡组患者年龄较大，入院时心率更快，体质指数、体表面积、血红蛋白、白蛋白水平更低，胱抑素C水平、脑钠肽升高比例、化疗及干细胞移植比例较高（P<0.05）。多因素Cox回归分析结果显示，体质指数升高〔HR=0.841，95%CI（0.761，0.930），P=0.001〕、接受化疗〔HR=0.340，95%CI （0.182，0.637），P=0.001〕、白蛋白水平升高〔HR=0.934，95%CI（0.889，0.982），P=0.008〕是全因死亡的独立保护因素，纤维蛋白原升高〔HR=1.635，95%CI（1.291，2.071），P<0.001〕、血小板计数<100×10⁹/L〔HR=2.500，95%CI（1.336，4.678），P=0.004〕是全因死亡的独立危险因素。

冠心病合并血液恶性肿瘤患者预后不佳，与全因死亡相关的危险因素为纤维蛋白原升高、血小板计数<100×10⁹/L。