Among 492 allogenic HSCT survivors, 26.8% were high CV risk with 61.6% hypertension, 56.1% dyslipidemia, and 19.3% manifest CV disease after 6.36 years.
What is the prevalence of cardiovascular risk factors and manifest cardiovascular disease in adult survivors of allogenic hematopoietic stem cell transplantation?
Allogenic HSCT survivors have a high burden of cardiovascular risk factors and manifest cardiovascular disease, highlighting the need for targeted cardiovascular screening and prevention in this population.
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Abstract Background Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for several hematologic conditions. Patients who underwent HSCT are at increased risk for cardiovascular (CV) events. Purpose We aimed to assess CV risk profiles in a large cohort of adult HSCT survivors and investigate potential sex differences. Methods We enrolled 492 patients who underwent allogenic HSCT between 1995 – 2021 into the COAST (Cardiovascular Outcome after Allogeneic Cell Transplantation) cohort study. CV risk profiling was performed between 2015 – 2023 and included a physical examination, ECG, transthoracic echocardiography, blood biomarkers, oxymetry and 24h blood pressure measurements. Assessed CV risk factors included obesity (BMI ≥30 kg/m²), hypertension (office BP 140/90 mmHg and/or 24h BP 130/80 mmHg), diabetes mellitus (HbA1c ≥6.5% or glucose-lowering therapy), dyslipidemia (LDL ≥3.0 mmol/L or lipid-lowering therapy), chronic kidney disease (eGFR 60 ml/min/1.73m²), current smoking, family history of premature CV disease or sleep apnea (AHI ≥15/h). Patients with 0–1 risk factor were classified as low risk, with 2–3 risk factors as medium risk, and with ≥4 risk factors or manifest CV disease as high risk. Results Overall, 192 (39%) patients were female, mean age was 53.01 ± 13.14 years and cardiac risk profiling was performed after a mean of 6.36 ± 5.37 years after allogenic HSCT. The most common indications for HSCT were acute myeloid leukemia (33%), acute lymphocytic leukemia (16%) and myelodysplastic syndrome (9.9%). The most common CV risk factors were hypertension (61.6%), dyslipidemia (56.1%), obesity (31.7%), and chronic kidney disease (21.1%). 95 patients (19.3%) had manifest CV disease (Figure). Overall patients had a mean of 2.03 ± 1.16 CV risk factors. Based on risk stratification, 130 individuals (26.4%) were classified as low risk, 230 (46.7%) as medium risk, and 132 (26.8%) as high risk. We found no significant sex-differences in the number of CV risk factors, manifest CV disease or risk classification. Conclusion In this cohort of allogenic HSCT survivors, we found a high prevalence of CV risk factors and prevalent CV disease. About half of the patients was classified as having medium CV risk and 1 out of 4 as having high CV risk. Our findings support targeted CV profiling and prevention strategies in long-term HSCT survivors.Graphical Abstract
Mutti et al. (Sat,) reported a other. Among 492 allogenic HSCT survivors, 26.8% were high CV risk with 61.6% hypertension, 56.1% dyslipidemia, and 19.3% manifest CV disease after 6.36 years.