University College Hospital, University College of London Hospitals NHS Foundation Trust, London NW1 2BU, UK.
John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.
Curr Res Transl Med. 2024 Mar;72(1):103420. doi: 10.1016/j.retram.2023.103420. Epub 2023 Oct 13.
Myeloproliferative neoplasms (MPNs) are a group of disorders of clonal haemopoiesis associated with an inherent risk of arterial and venous thrombotic complications. The prevalence of thrombotic complications and the impact of cardiovascular risk factors (CVRFs) in contemporary patient cohorts within the current era of MPN treatments have not been completely defined.
We aim to characterise the cardiovascular risk of patients with MPN by identifying the prevalence of CVRFs and describing the pattern of thrombotic events. We also aim to utilise the QRISK3 algorithm, which is a validated model used to estimate an individual's risk of developing cardiovascular disease, to further phenotype this cohort of patients.
We perform a retrospective analysis on a single-centre cohort of 438 patients with MPN.
MPN patients continue to carry a high burden of vascular morbidity with a prevalence of arterial thrombotic events in 15.8 % (69/438) and venous thrombotic events in 13.2 % (58/438) of the cohort. The novel use of the QRISK3 algorithm, which showed a mean score of 13.7 % across the MPN population, provides further evidence to suggest an increased cardiovascular risk in MPN patients.
With an increased risk of cardiovascular disease in patients with MPN, we propose an integrated approach between primary and specialised healthcare services using risk stratification tools such as QRISK3, which will allow aggressive optimisation of CVRFs to prevent thrombosis and reduce the overall morbidity and mortality in patients with MPN.
骨髓增殖性肿瘤(MPN)是一组与动脉和静脉血栓并发症固有风险相关的克隆性造血疾病。在当前 MPN 治疗时代,尚未完全确定血栓并发症的患病率以及心血管风险因素(CVRFs)对当代患者队列的影响。
我们旨在通过确定 CVRFs 的患病率并描述血栓事件的模式来确定 MPN 患者的心血管风险。我们还旨在利用 QRISK3 算法,该算法是一种用于估计个体患心血管疾病风险的验证模型,进一步表型分析该患者队列。
我们对单一中心的 438 名 MPN 患者进行回顾性分析。
MPN 患者继续承受着高血管发病率的负担,在该队列中,动脉血栓事件的患病率为 15.8%(69/438),静脉血栓事件的患病率为 13.2%(58/438)。QRISK3 算法的新应用表明,MPN 人群的平均评分为 13.7%,这进一步表明 MPN 患者的心血管风险增加。
由于 MPN 患者患心血管疾病的风险增加,我们建议在初级和专门医疗保健服务之间采用综合方法,使用 QRISK3 等风险分层工具,从而能够积极优化 CVRFs 以预防血栓形成,并降低 MPN 患者的整体发病率和死亡率。