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Geographic disparities in cardiovascular mortality among patients with myelodysplastic syndromes: A population-based

Diego Adrianzen-Herrera1, Andrew D Sparks2, Aditi Shastri3

  • 1Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.

Cancer Epidemiology
|August 15, 2022
PubMed

Insights

Rural patients with myelodysplastic syndromes (MDS) face a higher risk of cardiovascular death. This study highlights geographic disparities in cardiovascular outcomes for MDS patients, suggesting targeted interventions are needed.

Area of Science:

  • Hematology
  • Cardiology
  • Epidemiology

Background:

  • Clonal hematopoiesis, a precursor to myelodysplastic syndromes (MDS), is a recognized cardiovascular disease (CVD) risk factor.
  • Growing interest exists in understanding cardiovascular outcomes within the MDS population.
  • Rurality is linked to increased CVD risk, yet geographic disparities in cardiovascular health for MDS patients remain understudied.

Purpose of the Study:

  • To investigate the association between rural residence and cardiovascular death risk in patients diagnosed with myelodysplastic syndromes (MDS).
  • To identify potential geographic disparities in cardiovascular outcomes among MDS patients.

Main Methods:

  • Utilized the U.S. Surveillance, Epidemiology, and End Results (SEER) registry to identify 52,750 MDS patients from 2001-2016.
  • Defined rurality using Rural-Urban Continuum Codes.
  • Employed Cox regression to analyze the relationship between rurality and cardiovascular mortality.

Main Results:

  • MDS incidence rates were comparable between urban and rural populations.
  • Rural MDS patients exhibited a higher crude probability of cardiovascular death.
  • After adjusting for demographic factors and MDS risk, rural patients showed a 12% increased risk of CVD death (HR=1.12). The risk was more pronounced in the most rural areas and in patients younger than 65.

Conclusions:

  • Rural residence is associated with an increased burden of cardiovascular death among patients with myelodysplastic syndromes (MDS).
  • This disparity in CVD mortality is not attributable to demographic factors or MDS risk.
  • Targeted cardiovascular interventions may be crucial for improving outcomes in rural MDS populations.
Abstract

Keywords:
Cardiovascular diseasesHealth disparityMyelodysplastic syndromesRural health

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