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Published on: October 15, 2010
Reevaluation of cardiovascular risk factors for thrombotic events in 580 Japanese patients with essential
Chiho Furuya1, Yoshinori Hashimoto2,3, Soji Morishita3,4
1Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Insights
Cardiovascular risk factors, particularly high triglycerides, significantly increase thrombosis risk in essential thrombocythemia (ET). Managing these factors through lifestyle changes may help prevent thrombosis in ET patients.
Area of Science:
- Hematology
- Cardiovascular Medicine
- Oncology
Background:
- Essential thrombocythemia (ET) requires risk-adapted therapy to prevent thrombosis.
- Established risk factors for thrombosis in ET include advanced age, prior thrombosis, and JAK2V617F mutation.
- The influence of cardiovascular risk (CVR) factors on thrombosis in ET is not well understood.
Purpose of the Study:
- To investigate the impact of cardiovascular risk factors on thrombosis development in patients with essential thrombocythemia.
- To identify specific CVR factors that independently predict thrombosis risk in ET.
Main Methods:
- Analysis of data from 580 ET patients diagnosed according to the 2017 WHO Classification.
- Univariate and multivariate statistical analyses were performed to assess the association between CVR factors and thrombosis.
- Evaluation of thrombosis-free survival based on serum triglyceride levels and the number of CVR factors.
Main Results:
- Hypertriglyceridemia was identified as a significant risk factor for thrombosis in univariate analysis (HR 3.530, P=0.001).
- Multivariate analysis confirmed hypertriglyceridemia as an independent risk factor for thrombosis (HR 3.364, P=0.002).
- Patients with serum triglyceride levels ≥1.2 mmol/L or two or more CVR factors exhibited poorer thrombosis-free survival.
Conclusions:
- Cardiovascular risk factors, especially hypertriglyceridemia, play a significant role in thrombosis development in ET patients.
- Managing CVR factors, including controlling serum triglyceride levels, represents a potential strategy for thrombosis prevention in ET.
- Lifestyle interventions targeting modifiable CVR factors may improve outcomes for ET patients.
Abstract:
Risk-adapted therapy is recommended to prevent thrombosis in essential thrombocythemia (ET) patients. An advanced age, a history of thrombosis, and the presence of the JAK2V617F mutation are well-defined risk factors for thrombosis in ET; however, the impact of cardiovascular risk (CVR) factors on thrombosis in ET remains elusive. Therefore, we herein investigated the impact of CVR factors on thrombosis in 580 ET patients who met the 2017 World Health Organization Classification diagnostic criteria. A univariate analysis identified hypertriglyceridemia and multiple CVR factors as strong risk factors for thrombosis (hazard ratio [HR] 3.530, 95% confidence interval [CI] 1.630-7.643, P = 0.001 and HR 3.368, 95% CI 1.284-8.833, P = 0.014, respectively) and hyper-LDL cholesterolemia as a potential risk factor (HR 2.191, 95% CI 0.966-4.971, P = 0.061). A multivariate analysis revealed that hypertriglyceridemia was an independent risk factor for thrombosis (HR 3.364, 95% CI 1.541-7.346, P = 0.002). Furthermore, poor thrombosis-free survival was observed in patients with a serum triglyceride level ≥ 1.2 mmol/L (HR = 2.592, P = 0.026 vs. < 1.2 mmol/L) or two or more CVR factors (P = 0.011 vs. no CVR factors and P = 0.005 vs. one CVR factor). These results revealed the impact of CVR factors on thrombosis in ET. Since CVR factors are manageable, lifestyle interventions, such as the control of serum triglyceride levels, may effectively prevent thrombosis in ET patients.
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