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Researchers Analyzes Risk Between Hodgkin Disease and Heart Attack Mortality

Doctors have long known that patients treated for Hodgkin disease are at an increased risk for heart attacks. Researchers quantify the risk of fatal heart attacks// associated with different types of treatment, and they find that the increased risk persists for at least 25 years after Hodgkin disease treatment.

Hodgkin disease is a type of lymphoma that causes enlargement of lymph nodes, spleen, or other immune tissue. Cardiovascular disease is the second highest cause of death (after second cancers) in long-term survivors of Hodgkin disease, and myocardial infarction, or heart attack, is the most common cause of those cardiovascular deaths. This increased risk is related to the treatments for the disease.

To examine the heart attack mortality risk associated with specific drug treatment regimens and radiation, Anthony J. Swerdlow, D.Sc., of The Institute of Cancer Research in Sutton, United Kingdom, and colleagues studied a cohort of 7,033 patients treated for Hodgkin disease in Britain between 1967 and 2000.

Overall, there were 166 deaths from heart attacks among the patients in the cohort. This was two and a half times the number that would be expected in similar people from the general population in that time period. The increased risk of death from heart attack persisted for at least 25 years after treatment. The extra heart attack mortality risk attributed to treatment was three times higher in males than in females. When they looked at heart attack mortality risk according to treatment, they found that the risk was high among patients who received radiation treatment above the diaphragm, which can include parts of the heart. Among chemotherapy drugs, a class of drugs called anthracyclines carried the highest risk of subsequent death from heart attack. Among people who received neither radiotherapy above the diaphragm nor anthracyclines, the drug vincristine was associated with an increased risk of death from heart attacks.
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