Log in to MyACC
Cardiovascular Events After Hematopoietic Stem Cell Transplant
Quick Takes
- The incidence of CV events was relatively low within the first 100 days post-transplant in a contemporary cohort of adult hematopoietic stem cell transplantation (HSCT) recipients.
- The incidence of long-term CV events, particularly heart failure, was higher in allogeneic recipients and in those with pre-existing CV comorbidities.
- These findings underscore the importance of evaluating CV risk prior to stem cell transplant and the need for ongoing monitoring for CV complications long-term post-transplant.
Study Questions:
What is the incidence and what are the risk factors for short-term and long-term cardiovascular (CV) events in a contemporary cohort of adult hematopoietic stem cell transplantation (HSCT) recipients?
Methods:
The investigators conducted a multicenter observational study of adult patients who underwent autologous or allogeneic HSCT between 2008–2019. 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 (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 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%, p = 0.002). Baseline CV comorbidities were associated with a higher risk of long-term CV events.
Conclusions:
The authors report that incidence of short-term CV events in HSCT recipients is relatively low.
Perspective:
This observational study found that the incidence of CV events was relatively low within the first 100 days post-transplant in a contemporary cohort of adult HSCT recipients, with the most common event being atrial fibrillation or flutter. However, the incidence of long-term CV events, particularly heart failure, was higher in allogeneic recipients and in those with pre-existing CV comorbidities. These findings underscore the importance of evaluating CV risk prior to stem cell transplant and the need for ongoing monitoring for CV complications long-term post-transplant, especially with the shift towards older patients with greater age-related comorbidities receiving HSCT. Further studies are also indicated to develop optimal strategies for the prevention and management of these complications.
Clinical Topics: Arrhythmias and Clinical EP, Atrial Fibrillation/Supraventricular Arrhythmias
Keywords: Atrial Fibrillation, Bone Marrow Transplantation, Cardio-oncology, Hematopoietic Stem Cell Transplantation, Risk Factors
< Back to Listings
