Radiation heart disease patients are nearly twice as likely to experience a cardiac event as compared to the normal patient population undergoing similar types of cardiovascular surgery.
“Does that mean that if you had prior radiation you should never have heart surgery? The answer is clearly no,” says lead researcher and Cleveland Clinic cardiologist Milind Desai, MD. “These patients are at higher risk, and risk is a full spectrum. After appropriate risk stratification, carefully selected patients can safely undergo heart surgery.”
Dr. Desai explains the study findings and offers advice to heart patients with a history of chest radiation therapy in this video.
Radiation therapy and heart disease
Radiation therapy is an effective treatment for various types of cancer, but has been shown to cause future heart disease in patients who have had direct radiation to the chest, even years after cancer treatment. Patients with radiation heart disease tend to be younger and have conditions such as advanced coronary artery disease, valve disease and/or weakening of the heart muscle.
“There are ways to address and minimize the risk of developing radiation heart disease,” Dr. Desai says. “The good news is that with the evolution of radiation oncology techniques, they have started doing more targeted radiation, shielding other areas and reducing the dose to as little as possible to be effective.”
About the study
Dr. Desai and his research team at Cleveland Clinic looked at 178 patients with radiation-associated heart disease who had heart surgery. This group was compared with 305 patients who did not have radiation therapy but had the same type of heart surgery. Both groups of patients were followed for about seven years.
Results showed that patients with radiation-associated heart disease fared worse after surgery in the long-term mostly due to heart and lung problems.
In fact, people in the radiation heart disease group were twice as likely not to survive in the years following the surgery.
Dr. Desai’s advice
Dr. Desai notes that radiation can be a critical part of cancer treatment, but it is important to ask questions and make sure you are getting the most effective and least damaging dose.
Treatment for patients with radiation heart disease is “not a one-size fits all,” according to Dr. Desai. “Everyone needs evaluation in a center of excellence, and then a specific plan designed for them.”
Dr. Desai adds, “Future study needs to be directed at ways to identify the risks and better determine which patients would benefit from surgery versus other treatments, like percutaneous interventions.”
Complete results of the study can be found in the journal Circulation.