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Lymphoma and Long-Term cardiovascular disease risk: A comprehensive analysis from the UK biobank
Chenliang Ge1,2, Yan He1, Feng Huang1,3
1Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, Guangxi, 530021, China.
Insights
Lymphoma survivors face higher risks of cardiovascular diseases (CVDs), including heart failure and arrhythmias. Risk varies by lymphoma subtype, necessitating tailored cardiovascular monitoring for survivors.
Area of Science:
- Cardiovascular Medicine
- Oncology
- Epidemiology
Background:
- Lymphoma survivors are a growing population with potential long-term health risks.
- Cardiovascular diseases (CVDs) are a significant concern for this group, yet large-scale data is limited.
- Understanding specific CVD risks associated with lymphoma is crucial for survivor care.
Purpose of the Study:
- To investigate the association between lymphoma and incident CVDs.
- To explore variations in CVD risk across different lymphoma subtypes.
- To identify potential effect modifiers influencing these associations.
Main Methods:
- Retrospective cohort study utilizing UK Biobank data.
- Matched 3,244 lymphoma patients with 16,208 non-cancer controls.
- Multivariable Cox proportional hazards regression adjusted for demographic, lifestyle, and clinical factors.
Main Results:
- Lymphoma significantly increased risks for myocarditis/pericarditis (HR: 3.24), heart failure/cardiomyopathy (HR: 2.65), and atrial fibrillation/flutter (HR: 1.80).
- Elevated risks were also observed for valve diseases, conduction system disease, supraventricular arrhythmias, peripheral arterial disease, and ischemic heart disease.
- Diffuse Large B-cell Lymphoma (DLBCL) and T-cell lymphomas showed particularly high risks for certain CVD outcomes.
Conclusions:
- Lymphoma is associated with a substantially increased risk of multiple cardiovascular diseases.
- Cardiovascular risk assessment and management should be individualized for lymphoma survivors.
- Consideration of lymphoma subtype and patient-specific factors is essential for effective care.
Abstract:
Lymphoma survivors may face an increased risk of cardiovascular diseases (CVDs), but large-scale studies comprehensively assessing this risk are limited. This study aims to investigate the association between lymphoma and incident CVDs, and to explore differences across lymphoma subtypes and potential effect modifiers. This retrospective cohort study used UK Biobank data. 3,244 lymphoma patients were matched 1:5 to 16,208 non-cancer controls based on demographics, lifestyle, and health factors. Incident CVDs were ascertained from electronic health records. Multivariable Cox proportional hazards regression was used to assess the association between lymphoma and each cardiovascular outcome, adjusting for key demographic, lifestyle, and clinical factors. After multivariable adjustment, lymphoma was significantly associated with increased risks of myocarditis/pericarditis (HR: 3.24, 95% CI: 2.26-4.63), heart failure/cardiomyopathy (HR: 2.65, 95% CI: 2.26-3.11), atrial fibrillation/flutter (HR: 1.80, 95% CI: 1.58-2.04), valve diseases (HR: 1.80, 95% CI: 1.47-2.19), conduction system disease (HR: 1.65, 95% CI: 1.37-1.98), supraventricular arrhythmias (HR: 1.52, 95% CI: 1.07-2.17), peripheral arterial disease (HR: 1.47, 95% CI: 1.18-1.84), and ischemic heart disease (HR: 1.18, 95% CI: 1.04-1.34). Risk varied significantly across lymphoma subtypes, with Diffuse Large B-cell Lymphoma (DLBCL) and peripheral/cutaneous T-cell lymphomas exhibiting particularly elevated risks for several outcomes. Subgroup analyses indicated that age, sex, body mass index (BMI), and hypertension status significantly modified some associations. Lymphoma is associated with a significantly increased risk of multiple CVDs. Findings highlight the need for cardiovascular risk assessment and tailored management in lymphoma survivors, considering subtype and individual risk factors.
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