Long-term risks of cardiovascular-specific mortality among myeloproliferative neoplasms patients

Ther Adv Hematol. 2024 Oct 28:15:20406207241290886. doi: 10.1177/20406207241290886. eCollection 2024.

Abstract

Background: The myeloproliferative neoplasm (MPN) is a heterogeneous group of clonal hyperplasia hematopoietic stem cell disorders, predominantly affecting middle-aged and elderly individuals, with a slow disease progression. With advancements in disease-related research, the survival rates of MPN patients have significantly improved. This research primarily focuses on cardiovascular disease mortality (CVM) and prognostic factors in MPN patients, aiming to provide clinicians with more comprehensive references.

Methods: A total of 24,277 patients were included in the Surveillance, Epidemiology, and End Results (SEER) database. Cumulative mortality was assessed using a competing risk model, univariate and multivariate regression analysis of cardiovascular disease (CVD) mortality risk factors, and a comparison of standardized mortality ratio (SMR) and general population CVM.

Results: Among the 24,277 patients included in this study, a total of 8841 deaths occurred during the follow-up period, with 2429 attributed to CVD. Notably, the risk of CVM was found to be significantly higher in patients with MPNs compared to the general population. Furthermore, this risk increased over time. CVD emerged as the predominant cause of death among individuals aged over 80 years and younger patients exhibited a significantly elevated SMR. Additionally, age, race, marital status, and insurance status were identified as independent prognostic factors for CVM.

Conclusion: The incidence of cardiovascular events in patients with MPNs is significantly higher compared to the general population. Early screening and assessment of cardiac health should be implemented in MPN patients to prevent the occurrence of cardiovascular events and enhance their prognosis.

Keywords: Cox regression analysis; SEER; cardiovascular disease; competing risk; myeloproliferative neoplasm; standardized mortality ratio.

Plain language summary

Long-term risks of cardiovascular mortality in patients with MPNs MPN is a group of hematopoietic stem cell disorders that primarily affects middle-aged and elderly individuals, with slow disease progression. This study focuses on cardiovascular disease mortality (CVM) and prognostic factors in MPN patients to provide clinicians with comprehensive references. A total of 24,277 patients from the SEER database were included in this analysis. Cumulative mortality was assessed using a competing risk model, univariate and multivariate regression analysis identified CVD mortality risk factors, and standardized mortality ratio (SMR) was compared to the general population’s CVM rate. Among these patients, 8,841 deaths occurred during follow-up, with 2,429 attributed to CVD. MPN patients had a significantly higher risk of CVM compared to the general population which increased over time. CVD emerged as the leading cause of death among individuals aged over 80 years while younger patients exhibited an elevated SMR. Age, race, marital status, and insurance status were identified as independent prognostic factors for CVM. The incidence of cardiovascular events is significantly higher in MPN patients compared to the general population; therefore early screening and assessment of cardiac health should be implemented to prevent such events and improve prognosis.