Teng Guangshuai, Shang Ke, Zhang Yuhui, Duan Yifan, Du Chenxiao, Wang Yan, Li Yanqi, Zhang Huiqin, Peng Lan, Wei Xiaojing, Tse Gary, Zhou Yuan, Lip Gregory Y H, Liu Tong, Yang Wei, Duan Minghui, Bai Jie
Department of Hematology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Cancer Med. 2025 Jul;14(13):e71015. doi: 10.1002/cam4.71015.
The incidence, outcomes and risk factors for AF in the JAK2-positive MPN patients are still unknown.
The clinical profiles of patients with JAK2-positive MPN were retrospectively analyzed. Multivariable Cox regression analysis was performed to identify risk factors of AF, thereby developing a risk prediction model.
A total of 439 patients were included (age 57 [12-87] years; 51.3% male). AF was associated with higher risks of stroke (p = 0.036, HR = 1.987, 95% CI 1.047-3.772) and mortality (p < 0.001, HR = 3.857, 95% CI 1.836-8.103). Multivariable Cox regression showed that TET2 mutation (p = 0.042, HR = 4.361, 95% CI 1.053-18.056) and increased IL-1β (p = 0.012, HR = 5.476, 95% CI 1.547-28.123) were significant risk factors for AF in patients with JAK2-positive MPN. Nomograms were constructed, allowing patients to be categorized into high- and low-risk groups. The 10-year AF-free survival rate was significantly lower in the high-risk group (62% vs. 91.7%; log-rank test: p = 0.002). The validation cohort confirmed that the survival without AF in the high-risk group was significantly worse than that in the low-risk group. The use of either interferon-α or ruxolitinib, was associated with longer AF-free survival in the high-risk group (p < 0.05).
AF was significantly associated with higher risks of stroke and mortality. TET2 mutation and increased IL-1β were independent risk factors of AF in patients with JAK2-positive MPN.
JAK2 阳性骨髓增殖性肿瘤（MPN）患者中房颤的发病率、结局及危险因素仍不明确。
对 JAK2 阳性 MPN 患者的临床资料进行回顾性分析。采用多变量 Cox 回归分析确定房颤的危险因素，从而建立风险预测模型。
共纳入 439 例患者（年龄 57[12 - 87]岁；51.3%为男性）。房颤与较高的卒中风险（p = 0.036，HR = 1.987，95%CI 1.047 - 3.772）和死亡率（p < 0.001，HR = 3.857，95%CI 1.836 - 8.103）相关。多变量 Cox 回归显示，TET2 突变（p = 0.042，HR = 4.361，95%CI 1.053 - 18.056）和白细胞介素 - 1β升高（p = 0.012，HR = 5.476，95%CI 1.547 - 28.123）是 JAK2 阳性 MPN 患者房颤显著的危险因素。构建了列线图，可将患者分为高风险组和低风险组。高风险组的 10 年无房颤生存率显著较低（62%对 91.7%；对数秩检验：p = 0.002）。验证队列证实，高风险组无房颤生存情况显著差于低风险组。在高风险组中，使用干扰素 -α或鲁索替尼与更长的无房颤生存期相关（p < 0.05）。
房颤与较高的卒中和死亡风险显著相关。TET2 突变和白细胞介素 - 1β升高是 JAK2 阳性 MPN 患者房颤的独立危险因素。
