Abstract 19696: Hypertension and Elevated hs-CRP Predict Occult Cardiovascular Disease in Asymptomatic Survivors of Hodgkin's Lymphoma Treated with Chest Radiation
Background: Cardiovascular disease (CVD) is the leading cause of mortality in Hodgkin’s lymphoma (HL) survivors treated with chest radiation therapy (RT). The contribution of traditional cardiovascular risk factors (CRFs) to CVD development in this irradiated population is unclear since most studies are retrospective.
Methods: Two hundred and ten asymptomatic HL survivors treated with RT at 3 Harvard hospitals were recruited and assessed for treatment- and patient-related CRFs. Each patient underwent an outpatient cardiology visit and laboratory testing. Blood pressure (BP) measurement, electrocardiogram, and resting and stress echocardiography were performed. CVD detected on screening was correlated with patient-related CRFs.
Results: One hundred eighty-two HL survivors (59% female, mean age 44.1 ± 8.7 years, follow-up time 15.1 ± 7.2years) completed cardiac screening and formed the cohort. 81% of patients had ≥ 1 modifiable CRF. 26% (47) of patients (53% female, mean age 45.3 ± 9.0 years, follow-up time 16.9 ± 8.3 years) had occult coronary artery disease (CAD), at least moderate valve disease, or left ventricular systolic dysfunction (LVSD). Hypertension (OR=4.9, p=0.0003), elevated high-sensitivity C-reactive protein (hs-CRP) (OR=2.9, p=0.01), and older age (OR= 1.1, p=0.006) were correlated with CAD/valve disease. LVSD was not correlated with patient CRFs. For every 5mmHg decrease in systolic BP or in diastolic BP, the odds of CAD/valve disease decrease 22% or 26% respectively.
Conclusions: This is one of the most comprehensive prospective assessments of CRFs in HL survivors. Hypertension and hs-CRP are common and sensitive markers of CAD/valve disease in asymptomatic survivors treated with chest RT, and may allow better identification of those with occult CVD treated with chest radiation.
- © 2012 by American Heart Association, Inc.