Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study
Background: Thoracic radiotherapy is one of the corner stones of HL treatment, but it is associated with increased risk of cardiovascular events. As HL is often diagnosed at a young age, long-term follow-up including screening for coronary artery disease (CAD) is recommended. Objectives: This study...
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MDPI AG
2023-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/24/5831 |
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| author | Elissa A. S. Polomski Julius C. Heemelaar Michiel A. de Graaf Augustinus D. G. Krol Marloes Louwerens J. Lauran Stöger Paul R. M. van Dijkman Martin J. Schalij J. Wouter Jukema M. Louisa Antoni |
| author_facet | Elissa A. S. Polomski Julius C. Heemelaar Michiel A. de Graaf Augustinus D. G. Krol Marloes Louwerens J. Lauran Stöger Paul R. M. van Dijkman Martin J. Schalij J. Wouter Jukema M. Louisa Antoni |
| author_sort | Elissa A. S. Polomski |
| collection | DOAJ |
| description | Background: Thoracic radiotherapy is one of the corner stones of HL treatment, but it is associated with increased risk of cardiovascular events. As HL is often diagnosed at a young age, long-term follow-up including screening for coronary artery disease (CAD) is recommended. Objectives: This study aims to evaluate the presence of coronary artery calcium score (CACS) in relation to cardiovascular events in HL patients treated with thoracic radiotherapy compared to a non-cancer control group. Methods: Consecutive HL patients who underwent evaluation for asymptomatic CAD with coronary computed tomography angiography > 10 years after thoracic irradiation were included. The study population consisted of 97 HL patients matched to 97 non-cancer patients on gender, age, cardiovascular risk factors, and statin use. Results: Mean age during CT scan in the HL population was 45.5 ± 9.9 and in the non-cancer population 45.5 ± 10.3 years. CACS was elevated (defined as >0) in 49 (50.5%) HL patients and 30 (30.9%) control patients. HL survivors had an odds ratio of 2.28 [95% CI: 1.22–4.28] for having a CACS > 0 compared to the matched population (<i>p</i> = 0.006). Prevalence of CACS > 90th percentile differed significantly: 17.1% in HL survivors vs. 4.6% in the matched population (<i>p =</i> 0.009). Non-obstructive coronary artery stenosis was more prevalent in the HL population than in the control population (45.7% vs. 28.4%, respectively, <i>p</i> = 0.01). During follow-up of 8.5 [5.3; 9.9] years, nine HL patients experienced an event including two patients with a CACS of zero. No events occurred in the control population. Conclusion: In a matched study population, HL survivors have a higher prevalence of a CACS > 0 and an increased risk of cardiovascular events after thoracic irradiation compared to a matched non-cancer control group. |
| first_indexed | 2024-03-08T20:55:56Z |
| format | Article |
| id | doaj.art-9d3318291cae412097cce93584fba7e7 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T20:55:56Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9d3318291cae412097cce93584fba7e72023-12-22T13:59:00ZengMDPI AGCancers2072-66942023-12-011524583110.3390/cancers15245831Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort StudyElissa A. S. Polomski0Julius C. Heemelaar1Michiel A. de Graaf2Augustinus D. G. Krol3Marloes Louwerens4J. Lauran Stöger5Paul R. M. van Dijkman6Martin J. Schalij7J. Wouter Jukema8M. Louisa Antoni9Department of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsBackground: Thoracic radiotherapy is one of the corner stones of HL treatment, but it is associated with increased risk of cardiovascular events. As HL is often diagnosed at a young age, long-term follow-up including screening for coronary artery disease (CAD) is recommended. Objectives: This study aims to evaluate the presence of coronary artery calcium score (CACS) in relation to cardiovascular events in HL patients treated with thoracic radiotherapy compared to a non-cancer control group. Methods: Consecutive HL patients who underwent evaluation for asymptomatic CAD with coronary computed tomography angiography > 10 years after thoracic irradiation were included. The study population consisted of 97 HL patients matched to 97 non-cancer patients on gender, age, cardiovascular risk factors, and statin use. Results: Mean age during CT scan in the HL population was 45.5 ± 9.9 and in the non-cancer population 45.5 ± 10.3 years. CACS was elevated (defined as >0) in 49 (50.5%) HL patients and 30 (30.9%) control patients. HL survivors had an odds ratio of 2.28 [95% CI: 1.22–4.28] for having a CACS > 0 compared to the matched population (<i>p</i> = 0.006). Prevalence of CACS > 90th percentile differed significantly: 17.1% in HL survivors vs. 4.6% in the matched population (<i>p =</i> 0.009). Non-obstructive coronary artery stenosis was more prevalent in the HL population than in the control population (45.7% vs. 28.4%, respectively, <i>p</i> = 0.01). During follow-up of 8.5 [5.3; 9.9] years, nine HL patients experienced an event including two patients with a CACS of zero. No events occurred in the control population. Conclusion: In a matched study population, HL survivors have a higher prevalence of a CACS > 0 and an increased risk of cardiovascular events after thoracic irradiation compared to a matched non-cancer control group.https://www.mdpi.com/2072-6694/15/24/5831Hodgkin lymphomaradiotherapycoronary artery calcium scorecoronary artery disease |
| spellingShingle | Elissa A. S. Polomski Julius C. Heemelaar Michiel A. de Graaf Augustinus D. G. Krol Marloes Louwerens J. Lauran Stöger Paul R. M. van Dijkman Martin J. Schalij J. Wouter Jukema M. Louisa Antoni Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study Cancers Hodgkin lymphoma radiotherapy coronary artery calcium score coronary artery disease |
| title | Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study |
| title_full | Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study |
| title_fullStr | Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study |
| title_full_unstemmed | Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study |
| title_short | Relation between Coronary Artery Calcium Score and Cardiovascular Events in Hodgkin Lymphoma Survivors: A Cross-Sectional Matched Cohort Study |
| title_sort | relation between coronary artery calcium score and cardiovascular events in hodgkin lymphoma survivors a cross sectional matched cohort study |
| topic | Hodgkin lymphoma radiotherapy coronary artery calcium score coronary artery disease |
| url | https://www.mdpi.com/2072-6694/15/24/5831 |
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