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Researchers looked at 173 people who had chest radiation treatment for cancer an average of 18 years before they required heart surgery. These patients were compared to 305 people who underwent similar heart surgeries but had no history of radiation therapy.
The death risk in the first 30 days after heart surgery was about the same for both groups. But during an average follow-up of nearly eight years, 55 percent of the patients in the radiation group died, compared with 28 percent of those in the nonradiation group, the investigators found.
The study was published April 8 in the journal Circulation.
"These findings tell us that if you had radiation, your likelihood of dying after major cardiac surgery is high," study author Dr. Milind Desai, an associate professor of medicine at the Cleveland Clinic, said in a journal news release.
"That's despite going into the surgery with a relatively low risk score. In patients who have had prior [chest] radiation, we need to develop better strategies of identifying appropriate patients that would benefit from surgical intervention. Alternatively, some patients might be better suited for [nonsurgical] procedures," Desai said.
"While radiation treatments done on children and adults in the late 1960s, '70s and '80s played an important role in cancer survival, the treatment often takes a toll on the heart," Desai explained.
"Survivors are at greater risk than people who do not have radiation to develop progressive coronary artery disease, aggressive valvular disease, as well as pericardial diseases, which affect the heart's surrounding structures," he said. "These conditions often require major cardiac surgery."
While the study found an association between chest radiation therapy for cancer and future risk of death after heart surgery, it did not establish a cause-and-effect relationship.
-- Robert Preidt
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