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Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity

BACKGROUND: Patients with chronic myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF), are at high risk of vascular complications. However, the magnitude of this is risk not well known and the possible effect of comor...

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Autores principales: Frederiksen, Henrik, Szépligeti, Szimonetta, Bak, Marie, Ghanima, Waleed, Hasselbalch, Hans Carl, Christiansen, Christian Fynbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830370/
https://www.ncbi.nlm.nih.gov/pubmed/31807079
http://dx.doi.org/10.2147/CLEP.S216787
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author Frederiksen, Henrik
Szépligeti, Szimonetta
Bak, Marie
Ghanima, Waleed
Hasselbalch, Hans Carl
Christiansen, Christian Fynbo
author_facet Frederiksen, Henrik
Szépligeti, Szimonetta
Bak, Marie
Ghanima, Waleed
Hasselbalch, Hans Carl
Christiansen, Christian Fynbo
author_sort Frederiksen, Henrik
collection PubMed
description BACKGROUND: Patients with chronic myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF), are at high risk of vascular complications. However, the magnitude of this is risk not well known and the possible effect of comorbidity is poorly understood. AIM: Our aim was to compare the risk of vascular diseases in patients with MPNs and matched comparisons from the general population and to study the effect modification of comorbidity. METHODS: We followed 3087 patients with ET, 6076 with PV, 3719 with PMF or unspecified MPN, and age- and sex-matched general population comparisons to estimate the risks of cardiovascular diseases such as myocardial infarction and stroke. We computed 5-year cumulative incidences (risks) for vascular disease in patients with MPNs and comparisons as well as 1-year and 5-year risks, risk differences, and hazard ratios (HRs) for vascular diseases comparing rates in each group of patients with their comparison cohort by level of comorbidity based on the Charlson Comorbidity Index (CCI) [score of 0 (low comorbidity), of 1–2 (moderate comorbidity), and of >2 (severe comorbidity)], as well as other comorbid conditions. RESULTS: The overall 5-year risk of vascular disease ranged from 0.5% to 7.7% in patients with MPNs, which was higher than the risk in the general population. In the same period, the adjusted HRs for vascular disease were 1.3 to 3.7 folds higher in patients with MPNs compared to the general population. An increase in CCI score was associated with an equally increased rate of most types of vascular diseases during the first 5 years of follow-up in both MPN and comparisons. CONCLUSION: Patients with MPNs have a higher risk of vascular diseases during the first 5 years than that of the general population; however, comorbidity modifies the rates similarly in MPN and in the general population.
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spelling pubmed-68303702019-12-05 Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity Frederiksen, Henrik Szépligeti, Szimonetta Bak, Marie Ghanima, Waleed Hasselbalch, Hans Carl Christiansen, Christian Fynbo Clin Epidemiol Original Research BACKGROUND: Patients with chronic myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF), are at high risk of vascular complications. However, the magnitude of this is risk not well known and the possible effect of comorbidity is poorly understood. AIM: Our aim was to compare the risk of vascular diseases in patients with MPNs and matched comparisons from the general population and to study the effect modification of comorbidity. METHODS: We followed 3087 patients with ET, 6076 with PV, 3719 with PMF or unspecified MPN, and age- and sex-matched general population comparisons to estimate the risks of cardiovascular diseases such as myocardial infarction and stroke. We computed 5-year cumulative incidences (risks) for vascular disease in patients with MPNs and comparisons as well as 1-year and 5-year risks, risk differences, and hazard ratios (HRs) for vascular diseases comparing rates in each group of patients with their comparison cohort by level of comorbidity based on the Charlson Comorbidity Index (CCI) [score of 0 (low comorbidity), of 1–2 (moderate comorbidity), and of >2 (severe comorbidity)], as well as other comorbid conditions. RESULTS: The overall 5-year risk of vascular disease ranged from 0.5% to 7.7% in patients with MPNs, which was higher than the risk in the general population. In the same period, the adjusted HRs for vascular disease were 1.3 to 3.7 folds higher in patients with MPNs compared to the general population. An increase in CCI score was associated with an equally increased rate of most types of vascular diseases during the first 5 years of follow-up in both MPN and comparisons. CONCLUSION: Patients with MPNs have a higher risk of vascular diseases during the first 5 years than that of the general population; however, comorbidity modifies the rates similarly in MPN and in the general population. Dove 2019-11-01 /pmc/articles/PMC6830370/ /pubmed/31807079 http://dx.doi.org/10.2147/CLEP.S216787 Text en © 2019 Frederiksen et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Frederiksen, Henrik
Szépligeti, Szimonetta
Bak, Marie
Ghanima, Waleed
Hasselbalch, Hans Carl
Christiansen, Christian Fynbo
Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title_full Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title_fullStr Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title_full_unstemmed Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title_short Vascular Diseases In Patients With Chronic Myeloproliferative Neoplasms – Impact Of Comorbidity
title_sort vascular diseases in patients with chronic myeloproliferative neoplasms – impact of comorbidity
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830370/
https://www.ncbi.nlm.nih.gov/pubmed/31807079
http://dx.doi.org/10.2147/CLEP.S216787
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