title: Thoracic radiotherapy in patients with lymphoma and restenosis after coronary stent placement.
abstract: OBJECTIVE
  The aim of this study was to assess the incidence of restenosis after coronary stenting in patients with lymphoma treated with thoracic radiation.
  
  
  BACKGROUND
  Patients with Hodgkin lymphoma treated with thoracic radiation have an increased incidence of coronary artery disease (CAD). The incidence of restenosis after percutaneous coronary interventions is completely unknown.
  
  
  METHODS
  This study included 12,626 consecutive patients with CAD treated with coronary stenting during a 10-year period. Within this cohort, three subgroups of patients were assessed: patients with lymphoma and previous thoracic radiation (15 patients), patients with lymphoma without thoracic radiation (7 patients) and patients without lymphoma or previous thoracic radiation (control group; 12,604 patients). Coronary stenting was performed after a median [25th; 75th percentiles] of 8 years [4; 17] after thoracic radiation. The primary end point of the study was restenosis at 6-month coronary angiography.
  
  
  RESULTS
  Six-month coronary angiography was performed in 14 patients (93%) in the group with lymphoma and radiation, 6 patients (86%) in the group with lymphoma without radiation and 10,032 patients (80%) in the control group (P = 0.38). Angiographic restenosis was found in 12 patients (85.7%) in the group with lymphoma and radiation, 1 patient (16.7%) in the group with lymphoma without radiation and 2,555 patients (25.5%) in the control group (P < 0.001). Multiple logistic regression identified thoracic radiation as an independent predictor of coronary restenosis (odds ratio 21.7, 95% confidence interval, 4.7-100.9, P < 0.001).
  
  
  CONCLUSIONS
  Patients with lymphoma treated with thoracic radiation have an increased risk of restenosis after coronary artery stenting.
authors.affiliation: Deutsches Herzzentrum, Technische Universität Munich, Munich, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schömig
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pache
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D003331:Coronary Vessels / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006689:Hodgkin Disease / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents