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Radiation Therapy and Risk of Cardiovascular DiseaseRadiation Therapy and Risk of Cardiovascular Disease

JAMA. 2004;292(4):433-434. doi:10.1001/jama.292.4.433-b
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AUTHOR INFORMATION

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

RADIATION THERAPY AND RISK OF CARDIOVASCULAR DISEASE

To the Editor: Dr Hull and colleagues1 found that radiation therapy was associated with an increased incidence of atherosclerotic events among patients with Hodgkin lymphoma. Many of these patients, however, were treated during a time when splenectomy was a common part of staging for Hodgkin disease. Splenectomy is a risk factor for myocardial infarction2 4 and other atherosclerotic events.3 I believe that the authors should have accounted for splenectomy status in their analysis.

References
Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy.  JAMA.2003;290:2831-2837.
PubMed
Robinette CD, Fraumeni Jr JF. Splenectomy and subsequent mortality in veterans of the 1939-45 war.  Lancet.1977;2:127-129.
PubMed
Schilling RF. Spherocytosis, splenectomy, strokes, and heart attacks.  Lancet.1997;350:1677-1678.
PubMed
Scholz KH, Hermann C, Tebbe U, Chemnitius JM, Helmchen U, Kreuzer H. Myocardial infarction in young patients with Hodgkin's disease-potential pathogenic role of radiotherapy, chemotherapy, and splenectomy.  Clin Invest.1993;71:57-64.
PubMed

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Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy.  JAMA.2003;290:2831-2837.
PubMed
Robinette CD, Fraumeni Jr JF. Splenectomy and subsequent mortality in veterans of the 1939-45 war.  Lancet.1977;2:127-129.
PubMed
Schilling RF. Spherocytosis, splenectomy, strokes, and heart attacks.  Lancet.1997;350:1677-1678.
PubMed
Scholz KH, Hermann C, Tebbe U, Chemnitius JM, Helmchen U, Kreuzer H. Myocardial infarction in young patients with Hodgkin's disease-potential pathogenic role of radiotherapy, chemotherapy, and splenectomy.  Clin Invest.1993;71:57-64.
PubMed
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