Considerable Subclinical Cardiac Disease in Childhood CA Survivors
Exposure to anthracycline and heart radiation tied to higher odds
WEDNESDAY, Jan. 6, 2016 (HealthDay News) -- Adult survivors of childhood cancer are at increased risk for subclinical cardiovascular disease, according to a study published online Jan. 5 in the Annals of Internal Medicine.
Daniel A. Mulrooney, M.D., from the St. Jude Children's Research Hospital and University of Tennessee Health Science Center in Memphis, and colleagues systematically assessed cardiac outcomes among 1,853 adult survivors of childhood cancer. Participants had received cancer-related cardiotoxic therapy at least 10 years earlier.
The researchers found that 7.4 percent of survivors had cardiomyopathy, 3.8 percent had coronary artery disease, 28.0 percent had valvular regurgitation or stenosis, and 4.4 percent had conduction or rhythm abnormalities (newly identified at the time of evaluation in 4.7, 2.2, 24.8, and 1.4 percent, respectively). Almost all survivors were asymptomatic. There was an increase in the prevalence of cardiac conditions with increasing age at evaluation, ranging from 3 to 24 percent among survivors aged 30 to 39 years to 10 to 37 percent among survivors aged 40 years or older. Exposure to anthracycline doses of 250 mg/m² or more correlated with increased odds of cardiomyopathy versus nonexposure in multivariable analysis (odds ratio, 2.7). The odds of cardiomyopathy were also increased for survivors exposed to heart radiation versus those not exposed (odds ratio, 1.9).
"Cardiovascular screening identified considerable subclinical disease among adult survivors of childhood cancer," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.