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骨髓增殖性肿瘤患者急性冠脉综合征后死亡或心血管事件的危险因素

Risk Factors for Death or Cardiovascular Events after Acute Coronary Syndrome in Patients with Myeloproliferative Neoplasms.

作者信息

Leiva Orly, Jenkins Andrew, Rosovsky Rachel P, Leaf Rebecca K, Goodarzi Katayoon, Hobbs Gabriela

机构信息

Division of Cardiovascular Medicine, Department of Medicine, New York University Langone Health, New York, NY 10016, USA.

Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.

出版信息

Hematol Rep. 2023 Jun 7;15(2):398-404. doi: 10.3390/hematolrep15020040.

Abstract

Patients with myeloproliferative neoplasms (MPNs) are at increased risk of cardiovascular disease (CVD), including acute coronary syndrome (ACS). However, data on long-term outcomes of patients with MPN who have had ACS and risk factors for all-cause death or CV events post-ACS hospitalization are lacking. We conducted a single-center study of 41 consecutive patients with MPN with ACS hospitalization after MPN diagnosis. After a median follow-up of 80 months after ACS hospitalization, 31 (76%) experienced death or a CV event (myocardial infarction, ischemic stroke, or heart failure hospitalization). After multivariable Cox proportional hazards regression, index ACS within 12 months of MPN diagnosis (HR 3.84, 95% CI 1.44-10.19), WBC ≥ 20 K/µL (HR 9.10, 95% CI 2.71-30.52), mutation (HR 3.71, 95% CI 1.22-11.22), and prior CVD (HR 2.60, 95% CI 1.12-6.08) were associated with increased death or CV events. Further studies are warranted to improve cardiovascular outcomes in this patient population.

摘要

骨髓增殖性肿瘤(MPN)患者发生心血管疾病(CVD)的风险增加,包括急性冠脉综合征(ACS)。然而,关于MPN合并ACS患者的长期预后以及ACS住院后全因死亡或心血管事件风险因素的数据尚缺乏。我们对41例MPN诊断后因ACS住院的连续患者进行了一项单中心研究。ACS住院后中位随访80个月,31例(76%)发生死亡或心血管事件(心肌梗死、缺血性中风或心力衰竭住院)。经过多变量Cox比例风险回归分析,MPN诊断后12个月内发生的首次ACS(HR 3.84,95%CI 1.44 - 10.19)、白细胞≥20 K/µL(HR 9.10,95%CI 2.71 - 30.52)、 突变(HR 3.71,95%CI 1.22 - 11.22)以及既往CVD(HR 2.60,95%CI 1.12 - 6.08)与死亡或心血管事件增加相关。有必要进行进一步研究以改善该患者群体的心血管结局。 (注:原文中“ mutation”处缺失具体突变类型信息)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea36/10298451/2eefdff6268c/hematolrep-15-00040-g001.jpg

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