Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: I agree with Dr Schilling's assessment
that one might expect a higher incidence of coronary artery disease in patients
without prior splenectomy, related to additional incidental cardiac exposure
with splenic irradiation. However, review of our data indicates that 10.7%
of patients with a prior splenectomy developed coronary artery disease vs
10.0% of patients without splenectomy (P = .87).
Similarly, carotid or subclavian artery disease developed in 7.5% of patients
with splenectomy vs 7.4% without splenectomy (P>.99).
We did find that clinically significant valve dysfunction developed in 8.8%
of patients with prior splenectomy vs only 4.3% without splenectomy, but this
difference was nonsignificant (P = .09).
Mendenhall NP. Radiation Therapy and Risk of Cardiovascular Disease—Reply. JAMA. 2004;292(4):433-434. doi:10.1001/jama.292.4.434-b