A new study sheds light on the hidden cardiovascular risks lurking in the critical first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). This raises urgent clinical implications for transplant teams and cardiologists alike. With keywords like cardiovascular complications, heart failure, and atrial arrhythmia now at the forefront of transplant care, this retrospective cohort analysis from 852 adult HSCT recipients signals a need for early intervention strategies.
Researchers observed that 5.55% of patients experienced significant cardiovascular (CV) events shortly after transplant. The most common were atrial arrhythmias (3.92%) and heart failure (2.07%). While relatively infrequent, these early cardiac events carried grave consequences: patients who developed nonfatal CV events had a sixfold increased risk of nonrelapse mortality (subhazard ratio 6.25; 95% CI: 2.83–13.79) and nearly six times the risk of all-cause mortality (hazard ratio 5.79; 95% CI: 2.87–11.68).
The analysis also identified two strong predictors of early CV complications. Age increased risk incrementally (SHR per year: 1.07; 95% CI: 1.03–1.13), while a left ventricular ejection fraction under 50% prior to transplant tripled the likelihood of events (SHR: 3.16; 95% CI: 1.43–6.98).
Conducted over an 18-year period from 2004 to 2022, this single-center study underscores the importance of rigorous cardiac monitoring and early risk stratification in HSCT patients. While these events were relatively uncommon, their disproportionate association with mortality calls for targeted strategies to improve post-transplant survival.
As the transplant community continues to push survival boundaries, cardiovascular health must now be firmly embedded in the post-transplant care paradigm.
