학술논문
Coronary artery calcium and cardiovascular outcomes in patients with lymphoma undergoing autologous hematopoietic cell transplantation.
Document Type
Academic Journal
Author
Wu S; Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Rhee JW; Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Iukuridze A; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Bosworth A; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Chen S; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Atencio L; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Manubolu V; Department of Cardiology, Lundquist Institute, Torrance, California, USA.; Bhandari R; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Jamal F; Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Mei M; Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Herrera A; Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Rodriguez F; Stanford Cardiovascular Institute, Stanford University, Stanford, California, USA.; Forman S; Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Nakamura R; Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Wong FL; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Budoff M; Department of Cardiology, Lundquist Institute, Torrance, California, USA.; Armenian SH; Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA.; Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California, USA.
Source
Publisher: Wiley Country of Publication: United States NLM ID: 0374236 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0142 (Electronic) Linking ISSN: 0008543X NLM ISO Abbreviation: Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Patients undergoing autologous hematopoietic cell transplantation (HCT) have a >2-fold risk of developing cardiovascular disease (CVD; heart failure, myocardial infarction, and stroke), compared to the general population. Coronary artery calcium (CAC) is predictive of CVD in nononcology patients but is not as well studied in patients who underwent HCT and survivors of HCT.The objective of this study was to examine the association between CAC and CVD risk and outcomes after HCT in patients with lymphoma.
Methods: This was a retrospective cohort study of 243 consecutive patients who underwent a first autologous HCT for lymphoma between 2009 and 2014. CAC (Agatston score) was determined from chest computed tomography obtained <60 days from HCT. Multivariable Cox regression analysis was used to calculate hazard ratio (HR) estimates and 95% confidence intervals (CIs), adjusted for covariates (age, conventional risk factors [e.g., hypertension and dyslipidemia], and cancer treatment).
Results: The median age at HCT was 55.7 years (range, 18.5-75.1 years), 59% were male, and 60% were non-Hispanic White. The prevalence of CAC was 37%. The 5-year CVD incidence for the cohort was 12%, and there was an incremental increase in the incidence according to CAC score: 0 (6%), 1-100 (20%), and >100 (32%) (p = .001). CAC was significantly associated with CVD risk (HR, 3.0; 95% CI, 1.2-7.5) and worse 5-year survival (77% vs. 50%; p < .001; HR, 2.0; 95% CI, 1.1-3.4), compared to those without CAC.
Conclusions: CAC is independently associated with CVD and survival after HCT. This highlights the importance of integrating readily available imaging information in risk stratification and decision-making in patients undergoing HCT, which sets the stage for strategies to optimize outcomes after HCT.
(© 2024 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Methods: This was a retrospective cohort study of 243 consecutive patients who underwent a first autologous HCT for lymphoma between 2009 and 2014. CAC (Agatston score) was determined from chest computed tomography obtained <60 days from HCT. Multivariable Cox regression analysis was used to calculate hazard ratio (HR) estimates and 95% confidence intervals (CIs), adjusted for covariates (age, conventional risk factors [e.g., hypertension and dyslipidemia], and cancer treatment).
Results: The median age at HCT was 55.7 years (range, 18.5-75.1 years), 59% were male, and 60% were non-Hispanic White. The prevalence of CAC was 37%. The 5-year CVD incidence for the cohort was 12%, and there was an incremental increase in the incidence according to CAC score: 0 (6%), 1-100 (20%), and >100 (32%) (p = .001). CAC was significantly associated with CVD risk (HR, 3.0; 95% CI, 1.2-7.5) and worse 5-year survival (77% vs. 50%; p < .001; HR, 2.0; 95% CI, 1.1-3.4), compared to those without CAC.
Conclusions: CAC is independently associated with CVD and survival after HCT. This highlights the importance of integrating readily available imaging information in risk stratification and decision-making in patients undergoing HCT, which sets the stage for strategies to optimize outcomes after HCT.
(© 2024 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)