Is CAD Risk Higher in Hodgkin Lymphoma Survivors?

Individuals with a history of Hodgkin lymphoma have higher prevalence and severity of coronary artery disease (CAD) after chest irradiation, according to a recent study.

In order to determine differences in prevalence, extent, severity, composition, and location of CAD in patients who received high dose mediastinal irradiation, researchers conducted a study involving 79 long-term survivors of Hodgkin lymphoma who were at least 10 years disease free and had received mediastinal radiotherapy.
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Computed tomography angiography (CTA) was used to identify CAD. Patients were matched 1:3 based on age, gender, diabetes, hypertension, hypercholesterolemia, family history for CAD, and smoking status.

Overall, less participants in the Hodgkin lymphoma group had no atherosclerosis on CTA than controls (42% vs 64%). Those in the Hodkin lymphoma group showed significantly more multi-vessel CAD, and had more coronary plaques in the left main, proximal LAD, proximal RCA, and proximal LCX, but the number of plaques in non-proximal segments did not differ.

“Mediastinal irradiated Hodgkin lymphoma survivors have a higher prevalence and extent of CAD compared with age, gender and risk factor matched controls. However, this higher extent of CAD is only due to the higher prevalence of prognostically important proximal stenosis,” the researchers concluded.

—Michael Potts

Van Rosendael AR, Daniels LA, Dimitriu-Leen AC, et al. Differences in presence, extent, severity, composition and location of coronary artery disease after mediastinal irradiation compared with matched controls [presented at ICNC 2017]. May 7, 2017. Vienna, Austria. Abstract P118.