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Cardiovascular events among recipients of hematopoietic stem cell transplantation-A systematic review and meta-analysis

Bone Marrow Transplantation volume 58, pages 478–490 (2023)Cite this article

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Abstract

Cardiovascular diseases are an emerging cause of mortality and morbidity in survivors of hematopoietic stem cell transplantation (HSCT); however, the incidence of cardiovascular events (CVEs) in this population is not well described. This systematic review summarizes the evidence on the incidence of CVEs in HSCT recipients. Medline and Embase were searched from inception to December 2020. Inclusion criteria were cohort studies and phase 3 randomized controlled trials that reported CVEs among adults who underwent HSCT for hematological malignancies. After reviewing 8386 citations, 57 studies were included. The incidence of CVEs at 100 days was 0.19 (95% CI: 0.17–0.21) per 100 person-days after autologous HSCT and 0.06 (95% CI: 0.05–0.07) per 100 person-days after allogeneic HSCT. This higher incidence after autologous HSCT was driven by reports of arrhythmia from one population-based study in patients with multiple myeloma. The incidence of long-term CVEs was 3.98 (95% CI; 3.44–4.63) per 1000 person-years in survivors of autologous HSCT and 3.06 (95% CI; 2.69–3.48) per 1000 person-years in survivors of allogeneic HSCT. CVEs remain an important but under-reported cause of morbidity and mortality in recipients of HSCT. Future studies are required to better understand the incidence and risk factors for CVEs in HSCT recipients.

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Fig. 1: Literature search flow diagram.

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Data availability

The authors declare that the datasets generated and analysed during the current study are available from the corresponding author on reasonable request. Requests may be sent to corresponding author, NA (Aghel@hhsc.ca or Nazanin.Aghel@phri.ca).

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Authors and Affiliations

  1. Division of Cardiology, Cardio-Oncology Program, McMaster University, and Population Health Research Institute Hamilton, Hamilton, ON, Canada

    N. Aghel & D. P. Leong

  2. Department of Pharmacy, Hamilton Health Sciences, Hamilton, ON, Canada

    M. Lui

  3. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

    V. Wang

  4. Department of Hematology, McMaster University, Hamilton, ON, Canada

    D. Khalaf, C. Hillis & K. Lepic

  5. Department of Oncology, McMaster University, Hamilton, ON, Canada

    H. Mian, M. Aljama, T. Berg & A. Garcia-Horton

  6. Department of Medicine, McMaster University, Hamilton, ON, Canada

    I. Walker, B. Leber & H. Masoom

  7. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada

    J. H. Lipton

  8. Health Sciences Library, McMaster University, Hamilton, ON, Canada

    J. Petropoulos

Authors
  1. N. Aghel
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  2. M. Lui
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  3. V. Wang
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  4. D. Khalaf
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  5. H. Mian
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  6. C. Hillis
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  7. I. Walker
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  8. B. Leber
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  9. J. H. Lipton
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  10. M. Aljama
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  11. K. Lepic
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  12. T. Berg
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  13. A. Garcia-Horton
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  14. J. Petropoulos
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  15. H. Masoom
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  16. D. P. Leong
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Contributions

NA, DL: study conception and design; NA, ML, and VW: screening for potentially eligible studies, extracting and data collection; NA, DL: analysis and interpretation of results; ML, VW: preparing tables; NA: preparing the draft manuscript with input from all authors. All authors reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to N. Aghel.

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The authors declare no competing interests.

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Aghel, N., Lui, M., Wang, V. et al. Cardiovascular events among recipients of hematopoietic stem cell transplantation-A systematic review and meta-analysis. Bone Marrow Transplant 58, 478–490 (2023). https://doi.org/10.1038/s41409-023-01928-2

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  • DOI: https://doi.org/10.1038/s41409-023-01928-2

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