Cardiovascular Risk in Patients with Hematological Malignancies: A Systematic Review and Meta-Analysis

Patients with hematologic malignancies (HMs) are at risk of future cardiovascular (CV) events. We therefore conducted a systematic review and meta-analysis to quantify their risk of future CV events. We searched Medline and EMBASE databases from inception until January 31, 2023 for relevant articles...

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Bibliographic Details
Published in:The American journal of cardiology Vol. 212; pp. 80 - 102
Main Authors: Yong, Jung Hahn, Mai, Aaron Shengting, Matetić, Andrija, Elbadawi, Ayman, Elgendy, Islam Y., Lopez-Fernandez, Teresa, Mamas, Mamas A.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.02.2024
Elsevier Limited
Subjects:
Blood cancer
Cancer
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - complications
Cardiovascular Diseases - epidemiology
Cerebral infarction
Congestive heart failure
Coronary vessels
Heart attacks
Heart Disease Risk Factors
Heart failure
Heart Failure - complications
Heart Failure - epidemiology
hematologic malignancy
Hematologic Neoplasms - complications
Humans
Ischemia
Leukemia
Lymphoma
Malignancy
Meta-analysis
Mortality
Multiple myeloma
Myelodysplastic syndromes
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - epidemiology
Non-Hodgkin's lymphoma
Patients
Population
Risk Factors
Sensitivity analysis
Stroke
Stroke - complications
Stroke - epidemiology
Systematic review
Tumors
Vein & artery diseases
cardiovascular disease
heart failure
hematologic malignancy
stroke
myocardial infarction
ISSN:0002-9149, 1879-1913, 1879-1913
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Summary:Patients with hematologic malignancies (HMs) are at risk of future cardiovascular (CV) events. We therefore conducted a systematic review and meta-analysis to quantify their risk of future CV events. We searched Medline and EMBASE databases from inception until January 31, 2023 for relevant articles using a combination of keywords and medical subject headings. Studies examining CV outcomes in patients with HM versus controls without HM were included. The outcomes of interest included acute myocardial infarction (AMI), heart failure (HF), and stroke. The outcomes were expressed as hazard ratios (HRs) and their 95% confidence intervals (CIs). This study is registered with PROSPERO at CRD42022307814. A total of 15 studies involving 1,960,144 cases (178,602 patients with HM and 1,781,212 controls) were included in the quantitative analysis. A total of 10 studies examined the risk of AMI, 5 examined HF, and 11 examined stroke. Compared with the control group, the HRs for HM for AMI, HF, and stroke were 1.65 (95% CI 1.29 to 2.09, p <0.001), 4.82 (95% CI 3.72 to 6.25, p <0.001), and 1.60 (95% CI 1.30 to 1.97, p <0.001), respectively. The sensitivity analysis of stroke risk based on lymphoma type showed an increased risk of stroke in patients with non-Hodgkin lymphoma compared with controls (HR 1.31, 95% CI 1.04 to 1.64, p = 0.03) but no significant difference for Hodgkin lymphoma (HR 1.67, 95% CI 0.86 to 3.23, p = 0.08). Patients with HM are at increased risk of future AMI, HF, and stroke, and these findings suggest that CV care of patients with HM should be considered as a growing priority.
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ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2023.11.039