Childhood Cancer Survivors at Increased Risk for Subclinical Cardiovascular Disease

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The risk for subclinical heart disease appears to be higher in adult survivors of childhood cancer.
The risk for subclinical heart disease appears to be higher in adult survivors of childhood cancer.

(HealthDay News) — Adult survivors of childhood cancer are at increased risk for subclinical cardiovascular disease, according to a study published in the Annals of Internal Medicine.

Daniel A. Mulrooney, MD, from the St. Jude Children's Research Hospital and University of Tennessee Health Science Center in Memphis, and colleagues systematically assessed cardiac outcomes among 1853 adult survivors of childhood cancer. Participants had received cancer-related cardiotoxic therapy at least 10 years earlier.

The researchers found that 7.4% of survivors had cardiomyopathy, 3.8% had coronary artery disease, 28.0% had valvular regurgitation or stenosis, and 4.4% had conduction or rhythm abnormalities (newly identified at the time of evaluation in 4.7%, 2.2%, 24.8%, and 1.4%, 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% among survivors aged 30 to 39 years to 10% to 37% among survivors aged 40 or older. 

Exposure to anthracycline doses of 250 mg/m² or more correlated with increased odds of cardiomyopathy vs nonexposure in multivariable analysis (odds ratio [OR]=2.7). The odds of cardiomyopathy were also increased for survivors exposed to heart radiation vs those not exposed (OR=1.9).

"Cardiovascular screening identified considerable subclinical disease among adult survivors of childhood cancer," the researchers wrote.

Two authors disclosed financial ties to the pharmaceutical industry.

Reference

  1. Mulrooney DA, Armstrong GT, Huang S, et al. Cardiac Outcomes in Adult Survivors of Childhood Cancer Exposed to Cardiotoxic Therapy: A Cross-sectional Study. Ann Intern Med. 2016;doi:10.7326/M15-0424.
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