Purpose The use of anthracycline chemotherapy is associated with heart failure (HF) among survivors of non-Hodgkin lymphoma (NHL). We aimed to understand the contribution of preexisting cardiovascular risk factors to HF risk among NHL survivors. Methods Using Danish registries, we identified adults diagnosed with aggressive NHL from 2000 to 2010 and sex- and age-matched general-population controls. We assessed HF from 9 months after diagnosis through 2012. We used Cox regression analysis to assess differences in risk for HF between survivors and general population controls. Among survivors only, preexisting cardiovascular factors (hypertension, dyslipidemia, and diabetes) and preexisting cardiovascular disease were ascertained. We used multivariable Cox regression to model the association of preexisting cardiovascular conditions on subsequent HF. Results Among 2,508 survivors of NHL and 7,399 controls, there was a 42% increased risk of HF among survivors compared with general population controls (hazard ratio [HR], 1.42; 95% CI, 1.07 to 1.88). Among survivors (median age at diagnosis, 62 years; 56% male), 115 were diagnosed with HF during follow-up (median years of follow-up, 2.5). Before NHL diagnosis, 39% had ≥ 1 cardiovascular risk factor; 92% of survivors were treated with anthracycline-containing regimens. In multivariable analysis, intrinsic heart disease diagnosed before lymphoma was associated with increased risk of HF (HR, 2.71; 95% CI, 1.15 to 6.36), whereas preexisting vascular disease had no association with HF ( P > .05). Survivors with cardiovascular risk factors had an increased risk of HF compared with those with none (for 1 v 0 cardiovascular risk factors: HR, 1.63; 95% CI, 1.07 to 2.47; for ≥ 2 v 0 cardiovascular risk factors: HR, 2.86; 95% CI, 1.56 to 5.23; joint P < .01). Conclusion In a large, population-based cohort of NHL survivors, preexisting cardiovascular conditions were associated with increased risk of HF. Preventive approaches should take baseline cardiovascular health into account.

中文翻译：

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非霍奇金淋巴瘤幸存者中预先存在的心血管风险和随后的心力衰竭

目的 在非霍奇金淋巴瘤 (NHL) 幸存者中，蒽环类化疗的使用与心力衰竭 (HF) 相关。我们旨在了解先前存在的心血管危险因素对 NHL 幸存者的 HF 风险的贡献。方法使用丹麦登记处，我们确定了从 2000 年到 2010 年被诊断为侵袭性 NHL 的成年人以及性别和年龄匹配的一般人群对照。我们评估了从诊断后 9 个月到 2012 年的 HF。我们使用 Cox 回归分析来评估幸存者和一般人群对照之间的 HF 风险差异。仅在幸存者中，确定预先存在的心血管因素（高血压、血脂异常和糖尿病）和预先存在的心血管疾病。我们使用多变量 Cox 回归来模拟先前存在的心血管疾病与随后的 HF 之间的关联。结果 在 2,508 名 NHL 幸存者和 7,399 名对照者中，与一般人群对照相比，幸存者的 HF 风险增加了 42%（风险比 [HR]，1.42；95% CI，1.07 至 1.88）。在幸存者中（诊断时的中位年龄为 62 岁；56% 为男性），115 人在随访期间被诊断为 HF（中位随访年为 2.5）。在 NHL 诊断前，39% 有 ≥ 1 个心血管危险因素；92% 的幸存者接受了含蒽环类药物的治疗。在多变量分析中，淋巴瘤之前诊断出的内源性心脏病与 HF 风险增加相关（HR，2.71；95% CI，1.15 至 6.36），而先前存在的血管疾病与 HF 无关（ P > .05）。与没有心血管危险因素的幸存者相比，有心血管危险因素的幸存者发生 HF 的风险增加（对于 1 v 0 心血管危险因素：HR，1.63；95% CI，1.07 至 2.47；对于≥ 2 v 0 心血管危险因素：HR，2.86；95% CI，1.56 至 5.23；联合 P < .01）。结论 在一个基于人群的大型 NHL 幸存者队列中，预先存在的心血管疾病与 HF 风险增加相关。预防方法应考虑基线心血管健康。