Cardiovascular disease is the second highest cause of death in long-term survivors of Hodgkin disease. This increased risk is related to the treatments for the disease.
Overall, there were 166 deaths from heart attacks among the patients in the study. This was two and a half times the number that would be expected in similar people from the general population in that time period. The increased risk of death from heart attack persisted for at least 25 years after treatment.
When they looked at heart attack mortality risk according to treatment, they found that the risk was high among patients who received radiation treatment above the diaphragm, which can include parts of the heart.
Among chemotherapy drugs, a class of drugs called anthracyclines carried the highest risk of subsequent death from heart attack. Among people who received neither radiotherapy above the diaphragm nor anthracyclines the drug vincristine was associated with an increased risk of death from heart attacks.
“Long-term studies that follow lymphoma survivors for many years, such as the one conducted by Swerdlow and colleagues, are needed to help better understand the processes and factors that worsen heart function, especially now that patients in remission are living to older ages when cardiac disease is common,” writes John Boice Jr, of the International Epidemiology Institute in Rockville.