Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.
Oncol Res Treat. 2020;43(10):526-530. doi: 10.1159/000509376. Epub 2020 Aug 7.
BACKGROUND/AIMS: Cardiovascular risk factors are not considered in the current scores for evaluation of the thrombotic risk in myeloproliferative neoplasms, and in polycythemia vera (PV) in particular. Cytoreduction is currently not indicated in low-risk patients with PV, despite the absence or presence of cardiovascular risk factors. Our purpose is to highlight how cardiovascular risk factors in patients with PV increase the thrombotic risk both in low- and high-risk patients.
We collected and analyzed data from 165 consecutive patients with a diagnosis of PV followed at our institution and compared the frequency of thrombosis in subgroups of patients distinguished by the presence or absence of cardiovascular risk factors. The statistic tools used to obtain the results were the χ2 and the Kruskal-Wallis test for frequencies, and the Kaplan-Meyer method as well as the log-rank test for analysis of survival data.
The major result obtained is that the frequency of thrombotic events in our population is strictly linked with the cardiovascular risk, and it increases with the number of risk factors. Moreover, survival significantly worsens with the number of cardiovascular risk factors, despite the classical PV risk stratification.
It should be useful to design perspective studies to determine the real influence of cardiovascular risk factors on the thrombotic risk for patients with PV and on survival in order to evaluate the opportunity to develop new specific therapeutic recommendations.
背景/目的：目前的血栓风险评分并未考虑到心血管危险因素，特别是在骨髓增殖性肿瘤和原发性血小板增多症（PV）中。尽管存在或不存在心血管危险因素，目前仍不建议对低危 PV 患者进行细胞减少治疗。我们的目的是强调 PV 患者的心血管危险因素如何增加低危和高危患者的血栓风险。
我们收集并分析了在我院就诊的 165 例 PV 患者的连续数据，并比较了存在或不存在心血管危险因素的患者亚组的血栓形成频率。用于获得结果的统计工具是χ2 和 Kruskal-Wallis 检验用于频率分析，以及 Kaplan-Meier 方法和对数秩检验用于生存数据分析。
主要结果是我们人群中的血栓事件频率与心血管风险密切相关，并随着危险因素数量的增加而增加。此外，尽管存在经典的 PV 风险分层，但心血管危险因素的数量与生存率显著恶化。
有必要设计前瞻性研究来确定心血管危险因素对 PV 患者的血栓风险和生存的实际影响，以便评估制定新的特定治疗建议的机会。
