Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with organ toxicities, including cardiovascular (CV) complications. Data on contemporary acute postallogeneic HSCT cardiac complications and their impact on survival are scant. Objectives: The aim of the study was to...
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Elsevier
2025-06-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X25001772 |
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| author | Nazanin Aghel, MD, MSc Vincent Wang, BHSc Darryl Leong, MD, PhD Michelle Lui, PharmD, MSc Livia Fu, BNSc, MN, RN(EC) Jasmine Kang, MD Dina Khalaf, MD Irwin Walker, MD Christopher Hillis, MD, MSc Brian Leber, MD Harry Klimis, MD, PhD Anne Holbrook, MD, PharmD, MSc Catherine Demers, MD, MSc Philip Joseph, MD, MSc Kylie Lepic, MD Alejandro Garcia-Horton, MD Tobias Berg, MD, PhD Jeffrey Howard Lipton, MD, PhD Mylinh Duong, MD, MSc Jane Turner, MD Jinhui Ma, PhD |
| author_facet | Nazanin Aghel, MD, MSc Vincent Wang, BHSc Darryl Leong, MD, PhD Michelle Lui, PharmD, MSc Livia Fu, BNSc, MN, RN(EC) Jasmine Kang, MD Dina Khalaf, MD Irwin Walker, MD Christopher Hillis, MD, MSc Brian Leber, MD Harry Klimis, MD, PhD Anne Holbrook, MD, PharmD, MSc Catherine Demers, MD, MSc Philip Joseph, MD, MSc Kylie Lepic, MD Alejandro Garcia-Horton, MD Tobias Berg, MD, PhD Jeffrey Howard Lipton, MD, PhD Mylinh Duong, MD, MSc Jane Turner, MD Jinhui Ma, PhD |
| author_sort | Nazanin Aghel, MD, MSc |
| collection | DOAJ |
| description | Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with organ toxicities, including cardiovascular (CV) complications. Data on contemporary acute postallogeneic HSCT cardiac complications and their impact on survival are scant. Objectives: The aim of the study was to determine the incidence of early CV events following allogeneic HSCT and their effect on survival within the first 100 days. Methods: We conducted a single-center retrospective cohort study of adult patients who underwent allogeneic HSCT between 2004 and 2022. CV outcomes were a composite of CV death, myocardial infarction, heart failure, arrhythmia, stroke, or transient ischemic attack in early (≤100 days) postallogeneic HSCT. Results: The 100-day cumulative incidences of CV events in 852 patients (median age: 54 years; 58.57% male) was 5.55% (95% CI: 4.13%-7.26%). The most frequent cardiac event was atrial arrhythmia (cumulative incidence: 3.92% [95% CI: 2.84%-5.56%]), followed by heart failure (cumulative incidence: 2.07% [95% CI: 1.26%-3.24%]). Age (subhazard ratio [SHR] per year: 1.07; 95% CI: 1.03-1.13) and left ventricular ejection fraction <50% before transplant (SHR: 3.16; 95% CI: 1.43-6.98) were independently associated with increased risk of CV events. Nonfatal CV events during the first 100 days were independently associated with an increased hazard of nonrelapse mortality (SHR: 6.25; 95% CI: 2.83-13.79) and all-cause mortality (HR: 5.79; 95% CI: 2.87-11.68). Conclusions: Although CV events are relatively uncommon in the first 100 days in patients after allogeneic HSCT, the occurrence of CV events is associated with high nonrelapse and all-cause mortality rates. Close monitoring of patients who develop CV events is recommended. |
| format | Article |
| id | doaj-art-8b9fb80fcc744c288b96edef43ae49ae |
| institution | OA Journals |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-8b9fb80fcc744c288b96edef43ae49ae2025-08-20T02:26:10ZengElsevierJACC: Advances2772-963X2025-06-014610176010.1016/j.jacadv.2025.101760Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell TransplantationNazanin Aghel, MD, MSc0Vincent Wang, BHSc1Darryl Leong, MD, PhD2Michelle Lui, PharmD, MSc3Livia Fu, BNSc, MN, RN(EC)4Jasmine Kang, MD5Dina Khalaf, MD6Irwin Walker, MD7Christopher Hillis, MD, MSc8Brian Leber, MD9Harry Klimis, MD, PhD10Anne Holbrook, MD, PharmD, MSc11Catherine Demers, MD, MSc12Philip Joseph, MD, MSc13Kylie Lepic, MD14Alejandro Garcia-Horton, MD15Tobias Berg, MD, PhD16Jeffrey Howard Lipton, MD, PhD17Mylinh Duong, MD, MSc18Jane Turner, MD19Jinhui Ma, PhD20Division of Cardiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Hamilton Health Sciences, Hamilton, Ontario, Canada; Address for correspondence: Dr Nazanin Aghel, Division of Cardiology, McMaster University, A3-78 Juravinski Hospital, Hamilton, Ontario L8V 1C3, Canada.Hamilton Health Sciences, Hamilton, Ontario, CanadaDivision of Cardiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada; Hamilton Health Sciences, Hamilton, Ontario, CanadaHamilton Health Sciences, Hamilton, Ontario, CanadaHamilton Health Sciences, Hamilton, Ontario, CanadaMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Hematology, McMaster University, Hamilton, Ontario, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Hematology, McMaster University, Hamilton, Ontario, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaUniversity of Sydney, Sydney, AustraliaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Division of Clinical Pharmacology and Toxicology, McMaster University, Hamilton, Ontario, CanadaDivision of Cardiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaDivision of Cardiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Hematology, McMaster University, Hamilton, Ontario, CanadaDepartment of Oncology, McMaster University, Hamilton, Ontario, Canada; Centre for Discovery in Cancer Research, McMaster University, Hamilton, Ontario, Canada; Escarpment Cancer Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, CanadaPrincess Margaret Cancer Centre, Toronto, Ontario, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaHamilton Health Sciences, Hamilton, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaBackground: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with organ toxicities, including cardiovascular (CV) complications. Data on contemporary acute postallogeneic HSCT cardiac complications and their impact on survival are scant. Objectives: The aim of the study was to determine the incidence of early CV events following allogeneic HSCT and their effect on survival within the first 100 days. Methods: We conducted a single-center retrospective cohort study of adult patients who underwent allogeneic HSCT between 2004 and 2022. CV outcomes were a composite of CV death, myocardial infarction, heart failure, arrhythmia, stroke, or transient ischemic attack in early (≤100 days) postallogeneic HSCT. Results: The 100-day cumulative incidences of CV events in 852 patients (median age: 54 years; 58.57% male) was 5.55% (95% CI: 4.13%-7.26%). The most frequent cardiac event was atrial arrhythmia (cumulative incidence: 3.92% [95% CI: 2.84%-5.56%]), followed by heart failure (cumulative incidence: 2.07% [95% CI: 1.26%-3.24%]). Age (subhazard ratio [SHR] per year: 1.07; 95% CI: 1.03-1.13) and left ventricular ejection fraction <50% before transplant (SHR: 3.16; 95% CI: 1.43-6.98) were independently associated with increased risk of CV events. Nonfatal CV events during the first 100 days were independently associated with an increased hazard of nonrelapse mortality (SHR: 6.25; 95% CI: 2.83-13.79) and all-cause mortality (HR: 5.79; 95% CI: 2.87-11.68). Conclusions: Although CV events are relatively uncommon in the first 100 days in patients after allogeneic HSCT, the occurrence of CV events is associated with high nonrelapse and all-cause mortality rates. Close monitoring of patients who develop CV events is recommended.http://www.sciencedirect.com/science/article/pii/S2772963X25001772allogeneic stem cell transplantationatrial fibrillationcardiovascular eventsheart failureleft ventricular dysfunctionnonrelapse mortality |
| spellingShingle | Nazanin Aghel, MD, MSc Vincent Wang, BHSc Darryl Leong, MD, PhD Michelle Lui, PharmD, MSc Livia Fu, BNSc, MN, RN(EC) Jasmine Kang, MD Dina Khalaf, MD Irwin Walker, MD Christopher Hillis, MD, MSc Brian Leber, MD Harry Klimis, MD, PhD Anne Holbrook, MD, PharmD, MSc Catherine Demers, MD, MSc Philip Joseph, MD, MSc Kylie Lepic, MD Alejandro Garcia-Horton, MD Tobias Berg, MD, PhD Jeffrey Howard Lipton, MD, PhD Mylinh Duong, MD, MSc Jane Turner, MD Jinhui Ma, PhD Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation JACC: Advances allogeneic stem cell transplantation atrial fibrillation cardiovascular events heart failure left ventricular dysfunction nonrelapse mortality |
| title | Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full | Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation |
| title_fullStr | Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full_unstemmed | Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation |
| title_short | Early Cardiovascular Events in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation |
| title_sort | early cardiovascular events in recipients of allogeneic hematopoietic stem cell transplantation |
| topic | allogeneic stem cell transplantation atrial fibrillation cardiovascular events heart failure left ventricular dysfunction nonrelapse mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X25001772 |
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