Cardiovascular Conditions and Heart Failure in Survivors of Non-Hodgkin Lymphoma

09/21/17

A recent analysis examined the potential correlation between preexisting cardiovascular conditions and risk of heart failure in survivors of non-Hodgkin lymphoma, published in the Journal of Clinical Oncology (online September 18, 2017; doi:10.1200/JCO.2017.72.4211).

Survivors of non-Hodgkin lymphoma are at an increased risk for heart failure. Anthracycline-based chemotherapy is a definite contributor to increased risk, but preexisting conditions may also have a role as well.

Talya Salz, PhD, Memorial Sloan Kettering Cancer Center (New York, NY), and colleagues conducted a trial to determine whether preexisting cardiovascular risk factors are associated with heart failure among survivors of aggressive non-Hodgkin lymphoma. A total of 2508 patients were sampled from Danish registries who were diagnosed from 2000 to 2010. Heart failure was assessed from 9 months after diagnosis through 2012. Cox regression analysis was utilized to assess differences in risk for heart failure between the survivor cohort and a general population cohort (n = 7399).

Researchers noted preexisting cardiovascular factors (ie, hypertension, dyslipidemia, and diabetes) and preexisting cardiovascular disease in the survivor cohort. Multivariable Cox regression was utilized to model the association of preexisting cardiovascular factors on subsequent heart failure.

Researchers reported that there was a 42% increase in risk of heart failure in the survivor cohort, compared with the population cohort (HR, 1.42; 95% CI, 1.07-1.88).

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A total of 115 survivors were diagnosed with heart failure during follow-up (median follow-up, 2.5 years). Before initial non-Hodgkin lymphoma diagnosis, 39% had at least one cardiovascular risk factor. Ninety-two percent of survivors were treated with anthracycline-containing regimens for their lymphoma.

Multivariable analysis showed that heart disease diagnosed before non-Hodgkin lymphoma was associated with increased risk of heart failure (HR, 2.71; 95% CI, 1.15-6.36). Preexisting vascular disease was not associated with heart failure (P > .05). Additionally, researchers reported that survivors with cardiovascular risk factors demonstrated an increased risk of heart failure, compared with those without risk factors.

Authors of the study concluded that preexisting cardiovascular conditions are significantly associated with increased heart failure risk in survivors of non-Hodgkin lymphoma. “Preventive approaches should take baseline cardiovascular health into account,” they wrote.—Zachary Bessette