Cardiac Risk Assessed in Childhood Cancer Survivors
(HealthDay News) – Modifiable cardiovascular risk factors, particularly hypertension, add to the treatment-associated risk of major cardiac events in adult survivors of childhood cancer, according to research published online Sept. 3 in the Journal of Clinical Oncology.
Gregory T. Armstrong, MD, of St. Jude Children's Research Hospital in Memphis, TN, and colleagues conducted longitudinal follow-up of adults in the Childhood Cancer Survivor Study cohort to examine the relative contribution of modifiable cardiovascular risk factors on the development of major cardiac events.
The researchers found that, among 10,724 five-year survivors (median age, 33.7 years), the cumulative incidence of coronary artery disease, heart failure, valvular disease, and arrhythmia by age 45 was 5.3%, 4.8%, 1.5%, and 1.3%, respectively. The risk of each cardiac event was positively associated with the number of cardiovascular risk factors. Hypertension significantly increased the risk of heart failure (rate ratio [RR], 19.4), valvular disease (RR, 13.6), coronary artery disease (RR, 6.1), and arrhythmia (RR, 6). Chest-directed radiotherapy combined with hypertension potentiated the risk for each cardiac event to a greater extent than the expected additive effect.
"Modifiable cardiovascular risk factors, particularly hypertension, potentiate therapy-associated risk for major cardiac events in this population and should be the focus of future interventional studies," the authors write.