Exercise and risk of major cardiovascular events in adult survivors of childhood Hodgkin lymphoma: A report from the Childhood Cancer Survivor Study Journal Article
| Authors: | Jones, L. W.; Liu, Q.; Armstrong, G. T.; Ness, K. K.; Yasui, Y.; Devine, K.; Tonorezos, E.; Soares-Miranda, L.; Sklar, C. A.; Douglas, P. S.; Robison, L. L.; Oeffinger, K. C. |
| Article Title: | Exercise and risk of major cardiovascular events in adult survivors of childhood Hodgkin lymphoma: A report from the Childhood Cancer Survivor Study |
| Abstract: | Purpose: Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods: Survivors of HL (n = 1, 187; median age, 31. 2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4. 03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week-1) and risk of major CV events after adjustment for clinica covariates and cancer treatment. Results: Median follow-up was 11. 9 years (range, 1. 7 to 14. 3 years). Cumulative incidence of any CV event was 12. 2% at 10 years for survivors reporting 0 MET hours/week-1 compared with 5. 2% for those reporting ≥ 9 MET hours/week-1. In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (Ptrend =. 002). Compared with survivors reporting 0 MET hours/week-1, the adjusted rate ratio for any CV event was 0. 87 (95% CI, 0. 56 to 1. 34) for 3 to 6 MET hours/week-1, 0. 45 (95% CI, 0. 26 to 0. 80) for 9 to 12 MET hours/week-1, and 0. 47 (95% CI, 0. 23 to 0. 95) for 15 to 21 MET hours/week-1. Adherence to national vigorous intensity exercise guidelines (ie, ≥ 9 MET hours/week-1) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P =. 002). Conclusion: Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner ndependent of CV risk profile and treatment in survivors of HL. |
| Keywords: | adolescent; adult; cancer chemotherapy; controlled study; major clinical study; hypertension; cancer radiotherapy; comparative study; follow up; antineoplastic agent; cancer incidence; cohort analysis; exercise; obesity; retrospective study; childhood cancer; hodgkin disease; cancer survivor; cardiovascular risk; heart failure; diabetes mellitus; patient compliance; dyslipidemia; heart arrhythmia; anthracycline; coronary artery disease; metabolic equivalent; human; male; female; article; heart valve replacement |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 32 |
| Issue: | 32 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2014-11-10 |
| Start Page: | 3643 |
| End Page: | 3650 |
| Language: | English |
| DOI: | 10.1200/jco.2014.56.7511 |
| PROVIDER: | scopus |
| PMCID: | PMC4220043 |
| PUBMED: | 25311213 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2015 -- Source: Scopus |
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