Characteristics of symptomatic cardiovascular events in a 3-year single-center cardio-onco-hematology program in Poland (Cardio-Hemato-Oncology Programe CHOP-3Y)

Abstract The Cardio-Hemato-Oncology Program at the largest hematology center in the country included 2516 echocardiography tests performed on patients with hematological malignancies over three years,from January 2022 to December 2024. The majority of studies were performed on men (1327 / 52.74%). The average age of the evaluated patients was 58,14 years, with median age of 62 years and an interquartile range of 47-71 years. A significant proportion of echocardiography tests (1012 / 40,22%) were a part of a baseline risk assessment before cancer therapy. In our study, we decided to evaluate symptomatic patients undergoing hematooncological treatment because the current knowledge on this subject is minimal. Every fifth echocardiography test (507 / 20,15%) was performed due to emergency indications, indicating the occurrence of symptomatic cardiovascular events. New cardiovascular events were observed among patients with hematologic malignancies: acute myeloid leukemia (105 cases), myeloma (80), myelodysplastic syndrome (41), chronić myeloid leukemia (41), acute lymphocytic leukemia (39), non-Hodgkin lymphoma (38), chronic lymphocytic leukemia (32), Hodgkin lymphoma (28). The most common symptomatic events were: heart failure (212 cases), severe dyspnoea with multifactorial etiology (51 cases), arrthythmias (45 cases), fever with cardiac symptoms (38 cases), angina pectoris (32 cases), pericardial effusion (28 cases), acute pulmonary embolism/thromboembolism (19 cases), septic/cardiogenic shock (14 cases), tamponade (10 cases), syncope (8 cases), hypotension (7 cases). We identified the patients at significant risk of symptomatic cardiovascular events: patients with a history of arterial fibrillation (odds ratio= 1,52; 95%CI: 1,08-2,12; p=0,015) or heart failure (odds ratio=2,47; 95%CI: 1,83-3,32; p=0,000000003) or venous thromboembolism (odds ratio=1,7061; 95%CI: 1,18-2,46; p=0,004). Conclusions Symptomatic cardiovascular events are very common in cardio-hemato-oncology practice. We need a more focused and personalized approach for patients with hematological malignancies and a history of atrial fibrillation, heart failure and venous thromboemblism.