Cardiovascular Outcomes Associated With Exposure To Radiation Therapy In Thoracic Malignancies: An Insight Study...

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Thoracic irradiation is a common cancer treatment but poses cardiovascular risks.
• Short-term effects include pericardial diseases; long-term effects like heart failure and coronary artery disease manifest over decades.
• Predicting and establishing the link between radiation exposure and long-term cardiac issues is challenging.

Purpose of the Study:

• To investigate the association between thoracic radiation therapy (RT) and the prevalence of various cardiac outcomes in adult patients with thoracic malignancies.
• To compare cardiac outcomes in patients who received RT versus those who did not, and versus the general population.

Main Methods:

• Retrospective observational study using the National Inpatient Sample (NIS) database (2016-2019).
• Identified adult patients with primary thoracic malignancies who underwent RT.
• Excluded secondary malignancies and other RT-treatable cancers.
• Analyzed prevalence of heart failure, coronary artery disease, cardiomyopathy, conduction disorders, pericardial diseases, and valvular heart disease using multivariate logistic and linear regression.

Main Results:

• Adults with thoracic malignancies treated with RT showed significantly higher odds of developing chronic pericarditis (aOR=2.0), acute pericarditis (aOR=2.3), constrictive pericarditis (aOR=2.8), conduction disorders (aOR=1.3), coronary artery disease (aOR=1.24), heart failure (aOR=1.44), and valvular heart disease (aOR=1.37) compared to the general population.
• Compared to thoracic cancer patients not receiving RT, those who underwent RT had higher odds of acute myocardial infarction (aOR=1.14), chronic pericarditis (aOR=1.3), acute pericarditis (aOR=1.6), constrictive pericarditis (aOR=2.2), conduction disorders (aOR=1.1), coronary artery disease (aOR=1.14), heart failure (aOR=1.2), and valvular heart disease (aOR=1.3).
• No significant difference in cardiac arrest odds was observed between RT patients and the general population (aOR=1.0), but a slight increase was noted compared to non-RT cancer patients (aOR=0.86).

Conclusions:

• Thoracic radiation therapy (RT) is associated with increased odds of developing chronic pericarditis, acute pericarditis, constrictive pericarditis, conduction disorders, coronary artery disease, heart failure, and valvular heart disease.
• While cardiac arrest and acute myocardial infarction risks were not significantly elevated compared to the general population, RT patients showed increased odds for acute myocardial infarction when compared to non-RT thoracic cancer patients.
• Long-term cardiovascular surveillance is crucial for patients treated with thoracic radiation therapy.