Cardiovascular Events After Hematopoietic Stem Cell Transplant: Incidence and Risk Factors

Alexi Vasbinder, Christopher W. Hoeger, Tonimarie Catalan, Elizabeth Anderson, Catherine Chu, Megan Kotzin, Jeffrey Xie, Rayan Kaakati, Hanna P. Berlin, Husam Shadid, Daniel Perry, Michael Pan, Radhika Takiar, Kishan Padalia, Jamie Mills, Chelsea Meloche, Alina Bardwell, Matthew Rochlen, Pennelope Blakely, Monika LejaMousumi Banerjee, Mary Riwes, John Magenau, Sarah Anand, Monalisa Ghosh, Attaphol Pawarode, Gregory Yanik, Sunita Nathan, John Maciejewski, Tochukwu Okwuosa, Salim S. Hayek

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is associated with various cardiovascular (CV) complications. Objectives: 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. Methods: 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). Results: 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%; P = 0.002). Baseline CV comorbidities were associated with a higher risk of long-term CV events. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)821-832
Number of pages12
JournalJACC: CardioOncology
Volume5
Issue number6
DOIs
StatePublished - Dec 2023
Externally publishedYes

Keywords

  • atrial fibrillation
  • bone marrow transplant
  • cardiovascular disease
  • heart failure
  • hematopoietic stem cell transplant
  • risk factor

ASJC Scopus subject areas

  • Oncology
  • Cardiology and Cardiovascular Medicine

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