Agarwal Siddharth, Qamar Usama, Khan Muhammad Shahzeb, Al-Juhaishi Taha, Naqash Abdul Rafeh, Guha Avirup, Yang Eric H, Barac Ana, Ul Abideen Asad Zain
Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN 55905, USA.
Department of Medicine, King Edward Medical University, Lahore 54000, Pakistan.
Eur Heart J Open. 2024 Dec 18;5(1):oeae101. doi: 10.1093/ehjopen/oeae101. eCollection 2025 Jan.
We aimed to perform a retrospective cohort study using the Centers for Disease Control and Prevention's (CDC's) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database to analyse the trends in cardiovascular disease (CVD)-related mortality in patients with myeloproliferative neoplasms (MPNs) from 1999 to 2020.
We analysed the death certificate data from the CDC WONDER database from 1999 to 2020 for CVD with co-morbid myeloproliferative disorders in the US population. Age-adjusted mortality rates (AAMRs) and 95% confidence intervals (CIs) were computed per 1 million population by standardizing crude mortality rates to the 2000 US census population. To assess annual national mortality trends, we employed the Joinpoint regression model, calculating the annual per cent change in AAMR and corresponding 95% CIs. A total of 15 269 deaths related to CVD occurred in patients with co-morbid MPNs from 1999 to 2020. Overall, there was a decreasing trend in CVD-related AAMRs throughout these years. Males contributed to 51% of total deaths, and their AAMR was persistently higher than women throughout the study. Non-Hispanic (NH) Whites had the highest overall AAMR, followed by NH Blacks, NH American Indians or Alaska Natives, Hispanics or Latinos, and NH Asian or Pacific Islanders.
Our findings indicate a significant decline with notable gender, racial/ethnic, and regional differences in CVD-related mortality among patients with MPN over the past two decades. We emphasize the importance of a collaborative approach between oncologists and cardiologists in managing these patients, highlighting the potential benefits of integrating cardio-oncology services to enhance patient outcomes.
我们旨在利用美国疾病控制与预防中心（CDC）的广泛流行病学研究在线数据（WONDER）数据库进行一项回顾性队列研究，以分析1999年至2020年骨髓增殖性肿瘤（MPN）患者心血管疾病（CVD）相关死亡率的趋势。
我们分析了1999年至2020年美国人群中患有合并骨髓增殖性疾病的CVD患者的CDC WONDER数据库中的死亡证明数据。通过将粗死亡率标准化为2000年美国人口普查人口，计算出每百万人口的年龄调整死亡率（AAMR）和95%置信区间（CI）。为了评估年度全国死亡率趋势，我们采用了Joinpoint回归模型，计算AAMR的年度百分比变化和相应的95%CI。1999年至2020年，共有15269例与CVD相关的死亡发生在合并MPN的患者中。总体而言，这些年CVD相关的AAMR呈下降趋势。男性占总死亡人数的51%，在整个研究过程中，他们的AAMR一直高于女性。非西班牙裔（NH）白人的总体AAMR最高，其次是NH黑人、NH美洲印第安人或阿拉斯加原住民、西班牙裔或拉丁裔以及NH亚洲或太平洋岛民。
我们的研究结果表明，在过去二十年中，MPN患者CVD相关死亡率显著下降，且存在明显的性别、种族/民族和地区差异。我们强调肿瘤学家和心脏病学家在管理这些患者方面采用协作方法的重要性，突出整合心脏肿瘤学服务以改善患者预后的潜在益处。
