Cardiovascular Events After Hematopoietic Stem Cell Transplant: Incidence and Risk Factors.

作者信息

Vasbinder Alexi, Hoeger Christopher W, Catalan Tonimarie, Anderson Elizabeth, Chu Catherine, Kotzin Megan, Xie Jeffrey, Kaakati Rayan, Berlin Hanna P, Shadid Husam, Perry Daniel, Pan Michael, Takiar Radhika, Padalia Kishan, Mills Jamie, Meloche Chelsea, Bardwell Alina, Rochlen Matthew, Blakely Pennelope, Leja Monika, Banerjee Mousumi, Riwes Mary, Magenau John, Anand Sarah, Ghosh Monalisa, Pawarode Attaphol, Yanik Gregory, Nathan Sunita, Maciejewski John, Okwuosa Tochukwu, Hayek Salim S

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

出版信息

JACC CardioOncol. 2023 Sep 19;5(6):821-832. doi: 10.1016/j.jaccao.2023.07.007. eCollection 2023 Dec.

DOI:10.1016/j.jaccao.2023.07.007

PMID:38205002

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10774793/

Abstract

BACKGROUND

Hematopoietic stem cell transplantation (HSCT) is associated with various cardiovascular (CV) complications.

OBJECTIVES

We sought to characterize the incidence and risk factors for short-term and long-term CV events in a contemporary cohort of adult HSCT recipients.

METHODS

We conducted a multicenter observational study of adult patients who underwent autologous or allogeneic HSCT between 2008 and 2019. Data on demographics, clinical characteristics, conditioning regimen, and CV outcomes were collected through chart review. CV outcomes were a composite of CV death, myocardial infarction, heart failure, atrial fibrillation/flutter, stroke, and sustained ventricular tachycardia and were classified as short-term (≤100 days post-HSCT) or long-term (>100 days post-HSCT).

RESULTS

In 3,354 patients (mean age 55 years; 40.9% female; 30.1% Black) followed for a median time of 2.3 years (Q1-Q3: 1.0-5.4 years), the 100-day and 5-year cumulative incidences of CV events were 4.1% and 13.9%, respectively. Atrial fibrillation/flutter was the most common short- and long-term CV event, with a 100-day incidence of 2.6% and a 5-year incidence of 6.8% followed by heart failure (1.1% at 100 days and 5.4% at 5 years). Allogeneic recipients had a higher incidence of long-term CV events compared to autologous recipients (5-year incidence 16.4% vs 12.1%; 0.002). Baseline CV comorbidities were associated with a higher risk of long-term CV events.

CONCLUSIONS

The incidence of short-term CV events in HSCT recipients is relatively low. Long-term events were more common among allogeneic recipients and those with pre-existing CV comorbidities.

摘要