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Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data

Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was eva...

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Autores principales: Parasuraman, Shreekant, Yu, Jingbo, Paranagama, Dilan, Shrestha, Sulena, Wang, Li, Baser, Onur, Scherber, Robyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848033/
https://www.ncbi.nlm.nih.gov/pubmed/31552445
http://dx.doi.org/10.1007/s00277-019-03793-w
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author Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
author_facet Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
author_sort Parasuraman, Shreekant
collection PubMed
description Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.
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spelling pubmed-68480332019-11-22 Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data Parasuraman, Shreekant Yu, Jingbo Paranagama, Dilan Shrestha, Sulena Wang, Li Baser, Onur Scherber, Robyn Ann Hematol Original Article Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV. Springer Berlin Heidelberg 2019-09-24 2019 /pmc/articles/PMC6848033/ /pubmed/31552445 http://dx.doi.org/10.1007/s00277-019-03793-w Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title_full Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title_fullStr Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title_full_unstemmed Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title_short Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data
title_sort hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of veterans health administration data
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848033/
https://www.ncbi.nlm.nih.gov/pubmed/31552445
http://dx.doi.org/10.1007/s00277-019-03793-w
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