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
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.
JACC CardioOncol. 2023 Sep 19;5(6):821-832. doi: 10.1016/j.jaccao.2023.07.007. eCollection 2023 Dec.
Hematopoietic stem cell transplantation (HSCT) is associated with various cardiovascular (CV) complications.
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.
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).
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.
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.
造血干细胞移植（HSCT）与多种心血管（CV）并发症相关。
我们试图在当代成年HSCT受者队列中描述短期和长期CV事件的发生率及危险因素。
我们对2008年至2019年间接受自体或异基因HSCT的成年患者进行了一项多中心观察性研究。通过病历审查收集人口统计学、临床特征、预处理方案和CV结局的数据。CV结局是CV死亡、心肌梗死、心力衰竭、心房颤动/扑动、中风和持续性室性心动过速的综合指标，并分为短期（HSCT后≤100天）或长期（HSCT后>100天）。
在3354例患者（中位年龄55岁；40.9%为女性；30.1%为黑人）中，中位随访时间为2.3年（第一四分位数至第三四分位数：1.0 - 5.4年），CV事件的100天和5年累积发生率分别为4.1%和13.9%。心房颤动/扑动是最常见的短期和长期CV事件，100天发生率为2.6%，5年发生率为6.8%，其次是心力衰竭（100天时为1.1%，5年时为5.4%）。与自体受者相比，异基因受者长期CV事件的发生率更高（5年发生率16.4%对12.1%；P = 0.002）。基线CV合并症与长期CV事件的较高风险相关。
HSCT受者短期CV事件的发生率相对较低。长期事件在异基因受者和已有CV合并症的患者中更为常见。
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