Thoracic radiotherapy in patients with lymphoma and restenosis after coronary stent placement.
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.
Schömig
Kathrin
K
Deutsches Herzzentrum, Technische Universität Munich, Munich, Germany.
Ndrepepa
Gjin
G
Mehilli
Julinda
J
Pache
Jürgen
J
Kastrati
Adnan
A
Schömig
Albert
A
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