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患有缺血性心脏病的慢性髓性白血病患者的临床特征及院内死亡率:来自日本罗非昔布治疗骨关节炎试验(JROAD-DPC)注册研究的见解

Clinical characteristics and in-hospital mortality of chronic myeloid leukemia patients with ischemic heart disease: insights from the JROAD-DPC registry.

作者信息

Shindo Akito, Akazawa Hiroshi, Ueda Tomomi, Kadowaki Hiroshi, Ishida Junichi, Komuro Issei

机构信息

Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Eur Heart J Open. 2025 Aug 18;5(5):oeaf101. doi: 10.1093/ehjopen/oeaf101. eCollection 2025 Sep.

Abstract

AIMS

Chronic myeloid leukemia (CML) patients are at high risk for developing cardiovascular (CV) diseases due to adverse effects of BCR-ABL tyrosine kinase inhibitors.

OBJECTIVES

The purpose of this study was to compare patient characteristics and in-hospital mortality between CML patients and non-CML patients, who were hospitalized for ischemic heart disease (IHD).

METHODS AND RESULTS

This study was based on the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination (JROAD-DPC) database. All patients who were first hospitalized for IHD and received percutaneous coronary intervention from April 2012 to March 2021 were extracted. Propensity score matching was used to reduce confounding effects related to differences in patient background. A total of 766 385 patients, in which 371 CML patients were included, were analyzed. CML patients were more likely to be male and less likely to have obesity, hypertension, and dyslipidemia. The number of modifiable CV risk factors (obesity, smoking, hypertension, dyslipidemia, and diabetes mellitus) in CML patients was smaller than in non-CML patients. There was no difference in in-hospital mortality, whether considering all cases or only acute myocardial infarction cases. This was also statistically non-significant after propensity score matching.

CONCLUSION

CML patients were hospitalized for IHD with fewer CV risk factors than non-CML patients, and in-hospital mortality was comparable between CML and non-CML patients. These findings emphasize the need for more stringent management of modifiable CV risk factors for CML patients.

摘要

目的

由于BCR-ABL酪氨酸激酶抑制剂的不良反应,慢性髓性白血病(CML)患者发生心血管(CV)疾病的风险很高。

目标

本研究的目的是比较因缺血性心脏病(IHD)住院的CML患者和非CML患者的患者特征及院内死亡率。

方法与结果

本研究基于日本所有心血管疾病注册和诊断程序组合(JROAD-DPC)数据库。提取了2012年4月至2021年3月期间首次因IHD住院并接受经皮冠状动脉介入治疗的所有患者。采用倾向评分匹配来减少与患者背景差异相关的混杂效应。共分析了766385例患者,其中包括371例CML患者。CML患者更可能为男性,肥胖、高血压和血脂异常的可能性较小。CML患者中可改变的CV危险因素(肥胖、吸烟、高血压、血脂异常和糖尿病)的数量少于非CML患者。无论考虑所有病例还是仅急性心肌梗死病例,院内死亡率均无差异。倾向评分匹配后,这在统计学上也无显著差异。

结论

因IHD住院的CML患者的CV危险因素少于非CML患者,CML患者和非CML患者的院内死亡率相当。这些发现强调了对CML患者可改变的CV危险因素进行更严格管理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4199/12409409/2434e52b4de1/oeaf101_ga.jpg

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