Cardiotoxicity in Hematopoietic Stem Cell Transplant: Keeping the Beat

Area of Science:

• Cardiology
• Hematology
• Transplant Medicine

Background:

• The number of hematopoietic stem cell transplants (HSCT) is rising globally.
• Cardiac events are a known complication of HSCT, with consistent incidence and types over decades.

Purpose of the Study:

• To detail the incidence and types of cardiac events in allogeneic and autologous HSCT patients.
• To identify risk factors and patient characteristics associated with cardiac events post-HSCT.

Main Methods:

• Retrospective analysis of HSCT patients from 2012-2017 at a single institution.
• Multivariable regression analysis to identify significant risk factors for cardiac events.
• Subgroup analysis using echocardiogram data to assess atrial arrhythmia risk.

Main Results:

• 9.8% of patients experienced cardiac events, including atrial arrhythmia, heart failure, and acute coronary syndrome.
• Older age, elevated creatinine, and history of coronary artery disease were significant risk factors for cardiac events.
• Pre-transplant atrial dilation correlated with increased risk of atrial arrhythmia.
• Patients with cardiac events had a significantly higher risk of 1-year mortality.

Conclusions:

• Cardiac events remain a significant concern in HSCT, affecting nearly 10% of patients.
• Identifying high-risk patients through medical history, lab data, and cardiac imaging is crucial.
• Early intervention based on risk stratification can potentially improve HSCT outcomes.