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慢性髓性白血病的多学科管理可改善通过SCORE评估的心血管风险。

Multidisciplinary management in chronic myeloid leukemia improves cardiovascular risk measured by SCORE.

作者信息

Blanco Sánchez Alberto, Gil Manso Rodrigo, Carreño-Tarragona Gonzalo, Paredes Ruiz Diana, González Olmedo Jesús, Martínez-López Joaquín, Díaz Pedroche Carmen, Ayala Rosa

机构信息

Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Department of Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

Front Pharmacol. 2023 Jul 19;14:1206893. doi: 10.3389/fphar.2023.1206893. eCollection 2023.

Abstract

Cardiovascular events are one of the main long-term complications in patients with chronic myeloid leukemia (CML) receiving treatment with tyrosine kinase inhibitors (TKIs). The proper choice of TKI and the adequate management of risk factors may reduce cardiovascular comorbidity in this population. This study evaluated the cardiovascular risk of a cohort of patients with CML at diagnosis and after follow-up in a specialized cardiovascular risk consultation. In order to do this, we performed data analysis from 35 patients who received TKIs and were referred to the aforementioned consultation between 2015 and 2018 at our center. Cardiovascular risk factors were analyzed separately, as well as integrated into the cardiovascular SCORE, both at diagnosis and at the last visit to the specialized consultation. At the time of diagnosis, 60% had some type of risk factor, 20% had a high or very high risk SCORE, 40% had an intermediate risk, and 40% belonged to the low risk category. During follow-up, the main cardiovascular adverse event observed was hypertension (diagnosed in 8 patients, 23%). 66% of patients quit smoking, achieving control of blood pressure in 95%, diabetes in 50%, weight in 76%, and dyslipidemia in 92%. 5.7% of patients suffered a thrombotic event and a significant percentage of patients showed a reduction in their SCORE. Our study shows the benefit of controlling cardiovascular risk factors through follow-up in a specialized consultation for patients with CML treated with TKI.

摘要

心血管事件是接受酪氨酸激酶抑制剂(TKI)治疗的慢性髓性白血病(CML)患者的主要长期并发症之一。正确选择TKI并适当管理危险因素可能会降低该人群的心血管合并症。本研究评估了一组CML患者在诊断时以及在专门的心血管风险咨询随访后的心血管风险。为此,我们对2015年至2018年期间在我们中心接受TKI治疗并被转介至上述咨询的35例患者进行了数据分析。分别分析了心血管危险因素,并将其纳入心血管SCORE中,包括诊断时和最后一次到专门咨询就诊时。诊断时,60%的患者有某种类型的危险因素,20%的患者SCORE为高或非常高风险,40%为中度风险,40%属于低风险类别。随访期间,观察到的主要心血管不良事件是高血压(8例患者诊断出,占23%)。66%的患者戒烟,95%的患者血压得到控制,50%的患者血糖得到控制,76%的患者体重得到控制,92%的患者血脂异常得到控制。5.7%的患者发生血栓事件,相当比例的患者SCORE降低。我们的研究表明,通过对接受TKI治疗的CML患者进行专门咨询随访来控制心血管危险因素具有益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/10394626/eff24a7f7851/fphar-14-1206893-g001.jpg

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