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12 May 2017


High dose chest irradiation given to Hodgkin lymphoma patients increases risk for severe coronary artery disease, according to a new analysis.

Dr Alexander van Rosendael of Leiden University Medical Centre, the Netherlands, and colleagues examined details of the coronary artery disease suffered by a group of 79 Hodgkin lymphoma survivors who had received irradiation to the chest. Their coronary artery disease was assessed using coronary computed tomography angiography and compared against 273 similar people without Hodgkin lymphoma or irradiation.

Age, sex, diabetes, hypertension, hypercholesterolaemia, family history of coronary artery disease, and smoking status were taken into account in the analysis. Atherosclerosis affected 42% of patients and the healthy group. Average age on both groups was 45 years.

In terms of coronary artery disease extent and severity, Hodgkin survivors had significantly more multi-vessel coronary artery disease - 34% versus 15%. Scores for overall coronary plaque distribution and coronary plaque extent and severity were also significantly higher among Hodgkin survivors.

This group also tended to have significantly more coronary plaques in the left main (17% versus 6%), proximal left anterior descending (30% vs 16%), proximal right coronary artery (25% vs 10%) and proximal left circumflex (14% vs 6%).

Full details were presented on Sunday (7 May) at the International Conference on Nuclear Cardiology and Cardiac CT 2017 held in Vienna, Austria.

Dr van Rosendael says: 'What was remarkable was that irradiated patients had all the features of high risk coronary artery disease, including high stenosis severity, proximal location, and extensive disease.

'We know that the proximal location of the disease is much riskier and this may explain why Hodgkin patients have such poor cardiovascular outcomes when they get older.'

The study Differences in presence, extent, severity, composition and location of coronary artery disease after mediastinal irradiation compared with matched controls was displayed during Poster session I on 7 May 2017 at the International Conference on Nuclear Cardiology and Cardiac CT (ICNC 2017) which took place 7 to 9 May 2017 in Vienna, Austria.


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