Deaths and major cardiovascular events in patients with lymphoma: Analysis from a French nationwide hospitalization database

Abstract

Background: There are few data assessing the risk of death and cardiovascular events in patients with lymphoma.

Aim: Using a nationwide hospitalization database, we aimed to address cardiovascular outcomes in patients with lymphoma.

Methods: From 01 January to 31 December 2013, 3,381,472 adults were hospitalized in French hospitals; 22,544 of these patients had a lymphoma. The outcome analysis (all-cause or cardiovascular death, myocardial infarction, ischaemic stroke, bleedings, new-onset heart failure and new-onset atrial fibrillation) was performed over a 5-year follow-up period. Each patient with lymphoma was matched with a patient without a lymphoma or other cancer (1:1). A competing risk analysis was also performed.

Results: After adjustment on all risk factors, cardiovascular and non-cardiovascular co-morbidities, the subdistribution hazard ratios for all-cause death, major bleeding, intracranial bleeding, new-onset heart failure and new-onset atrial fibrillation were higher in patients with lymphoma; conversely, the subdistribution hazard ratios for cardiovascular death, myocardial infarction and ischaemic stroke were lower in patients with lymphoma. In the matched analysis, the risk of all-cause death (subdistribution hazard ratio 1.936, 95% confidence interval 1.881-1.992) and major bleeding (subdistribution hazard ratio 1.117, 95% confidence interval 1.049-1.188) remained higher in patients with lymphoma.

Conclusion: In this large nationwide cohort study, patients with lymphoma had a higher incidence of all-cause death and major bleeding.

Keywords: Bleeding; Ischaemic stroke; Lymphoma; Mortality; Myocardial infarction.