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Lifestyle factors associated with ischemic heart disease after hematopoietic cell transplantation
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Preventable lifestyle and cardiovascular factors appeared associated with ischemic heart disease and mortality among patients who had received hematopoietic cell transplantation, according to findings published in Cancer.
The results highlighted the need for healthy behaviors and treatment of cardiovascular risk factors in cancer survivors who underwent HCT.
“The increasing prevalence and effectiveness of hematopoietic [stem] cell transplantation have resulted in a growing population of long-term survivors of [HSCT],” Eric J. Chow, PhD, MPH, of the Fred Hutchinson Cancer Research Center, Seattle, and colleagues wrote. “Unfortunately, [HSCT] survivors suffer numerous long-term complications from their therapy, and cardiovascular disease is among the most significant of these complications. … Compared with the general population, [HSCT] survivors also have a higher burden of potentially modifiable conditions, such as hypertension, dyslipidemia and diabetes, that further increase the risk for subsequent serious cardiovascular disease.”
The researchers surveyed patients (n = 2,360) aged 20 years or older who had survived for at least 1 year after receiving [HSCT] between 1970 and 2010. Chow and colleagues followed survivors through 2016 for overall mortality and incident ischemic heart disease.
The patients’ median age at baseline was 55.9 years, and the median time since HSCT was 10.8 years.
Overall, 6.9% (n = 162) of participants reported having ischemic heart disease at baseline. The 5-year cumulative incidence of ischemic heart disease among those who did not report it at baseline was 4.3%.
Multiple lifestyle and cardiovascular factors, such as diabetes, physical inactivity, dyslipidemia and obesity appeared associated with an increased risk for developing ischemic heart disease (HR ≥ 1.8 for all).
However, greater intake of fruits and vegetables, as well as greater physical activity, appeared linked with lower overall mortality (HR ≤ 0.7).
Each additional adverse lifestyle factor and cardiovascular risk condition appeared independently linked with subsequent heart disease when the researchers jointly considered all factors (HR for lifestyle factors, 1.9; 95% CI, 1.2-2.9; HR for risk conditions, 1.4; 95% CI, 1-1.9). Further, adverse lifestyle factors appeared associated with mortality (HR = 1.8; 95% CI, 1.5-2.3).
“Our results support the importance of healthy lifestyle choices for cancer survivors, including those treated with [HSCT], and more aggressive screening and treatment of potentially modifiable cardiovascular risk conditions,” Chow and colleagues wrote. “A growing body of evidence suggests that interventions designed to improve diet and increase physical activity in cancer survivors can lead to short- and medium-term improvements. More research is needed to determine whether such improvements can persist in the longer term with meaningful impacts on subsequent health and quality of life.” – by Andy Polhamus
Disclosures: Chow reports no relevant financial disclosures. Please see the study for a complete list of all other authors’ relevant financial disclosures.
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Leger KJ, et al. Cancer. 2018;doi:10.1002/cncr.31227.
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