BACKGROUND
Hodgkin lymphoma (HL) survivors have significant cardiovascular risk and require long-term surveillance. This study assessed the prevalence of coronary artery disease (CAD) by coronary computed tomographic angiography (CCTA) in adult survivors of childhood HL.
METHODS
Thirty-one HL survivors, 13 (42%) treated with radiation therapy (RT) only and 18 (58%) with multimodal therapy, underwent CCTA, echocardiography, electrocardiography (ECG), and treadmill stress testing. Obstructive CAD was defined as ≥50% occlusion of the left main (LM) or ≥70% occlusion of the left anterior descending (LAD), left circumflex (LCx), or right coronary (RCA) arteries on CCTA. Echocardiograms with resting wall motion abnormalities or ejection fraction <50%; ECGs with Q waves, ST abnormalities without Q waves, or T-wave abnormalities without Q waves; and ≥1-mm J-point depression with horizontal or down-sloping ST segment on stress testing were considered abnormal.
RESULTS
Prevalence of disease in participants (median age, 40 years; range, 26–55; median time from cancer diagnosis, 24 years; range, 17–39) was 39%, with 39 plaques detected in 12 survivors. Three participants (10%) treated with RT only had 4 obstructive lesions; 9 (29%; 5 treated with RT only; 4 with multimodal therapy) had nonobstructive lesions. Approximately 15% of lesions involved the LM; 21%, proximal LAD; 18%, proximal RCA; and 13%, proximal LCx arteries. Of the 12 participants with CAD by CCTA, 7 had positive ECG; 1, positive echocardiography; and 1, a positive stress test.
CONCLUSIONS
CCTA identified CAD in a substantial portion of HL survivors and may be an effective screening modality for this population.