Key result
Post-transplant cardiovascular adverse events are linked to an absolute ~17% increase in all-cause mortality.
Why the study?
Cardiovascular adverse events are a notable source of morbidity and mortality after hematopoietic stem cell transplantation, but their incidence and impact on survival require quantification.
Does the occurrence of cardiovascular complications impact overall survival in adult patients following hematopoietic stem cell transplantation?
Cohort (n=145)
Does the occurrence of cardiovascular complications impact overall survival in adult patients following hematopoietic stem cell transplantation?
Absolute Event Rate: 29% vs 12%
p-value: p=0.003
Cardiovascular complications are common after hematopoietic stem cell transplantation, primarily occurring within the first six months, and serve as a powerful negative prognostic indicator for overall survival.
CV adverse events warrant monitoring given mortality link; leaves open whether targeted interventions improve survival in this population.
Background Hematopoietic stem cell transplantation (HSCT) serves as a first-line intervention for various hematologic malignancies. While advancements in safety have expanded eligibility to older patients and those with pre-existing comorbidities, cardiovascular (CV) adverse vents represent a notable source of morbidity and mortality. This registry sought to quantify the incidence of these CV complications and evaluate their specific impact on survival in the post-transplant period. Methods This regional observational cohort study consecutively enrolled adult patients undergoing autologous or allogeneic HSCT between 2019 and 2025. Participants underwent a dedicated screening protocol involving 12-lead ECGs, echocardiography, and cardiac biomarker assessment at baseline, 2, 6, and every six months post-transplant. The primary outcomes of interest included new-onset systolic dysfunction, thromboembolic events (VTE and PE), stroke, arrhythmias, pericarditis, and hypertensive crises. Results The study followed 145 patients with a mean age of 55±13 years for a median of 2.6 years (1.1-5.1 years). Although the prevalence of major CV risk factors was initially low, with only 17% of patients having a prior CV event, 39% of the cohort experienced at least one CV-related adverse event during the follow-up period. Specifically, clinicians identified 12 VTE/PE, 8 atrial fibrillation, 7 heart failure/cardiogenic shock, 5 peripheral vascular disease and 5 hypertensive crises (Figure 1). A significant majority of these events (68%) occurred within the first six months. Experiencing any kind of CV adverse event was associated with a more than twofold increase in all-cause mortality, rising from 12% to 29% (Figure 2; p=.003). Conclusions Cardiovascular complications are prevalent among HSCT recipients and can impact even relatively young and healthy individuals. The occurrence of a CV event is a powerful negative prognostic indicator for overall survival, and most of them occur within the first six months.Cardiovascular adverse events Overall survival according to CV events
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Guerra et al. (2026) conducted a cohort in Hematologic malignancies post-hematopoietic stem cell transplantation (n=145). Cardiovascular adverse events vs. No cardiovascular adverse events was evaluated on All-cause mortality (p=0.003). Experiencing a cardiovascular adverse event post-transplantation was associated with an increase in all-cause mortality from 12% to 29% (P=0.003).
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