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Multidisciplinary management in chronic myeloid leukemia improves cardiovascular risk measured by SCORE
Alberto Blanco Sánchez1, Rodrigo Gil Manso1, Gonzalo Carreño-Tarragona1
1Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Insights
Managing cardiovascular risk factors in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs) through specialized consultations significantly improves outcomes. This approach helps reduce cardiovascular events and manage risk factors effectively.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Cardiovascular events are a major long-term complication for chronic myeloid leukemia (CML) patients on tyrosine kinase inhibitor (TKI) therapy.
- Optimizing TKI selection and managing cardiovascular risk factors are crucial for mitigating comorbidity in this patient group.
Purpose of the Study:
- To evaluate the cardiovascular risk in CML patients at diagnosis and during follow-up within a specialized cardiovascular risk consultation.
- To analyze the impact of risk factor management on cardiovascular health in CML patients receiving TKIs.
Main Methods:
- Retrospective analysis of 35 CML patients treated with TKIs from 2015-2018.
- Assessment of cardiovascular risk factors and SCORE at diagnosis and during follow-up.
- Evaluation of interventions in a specialized cardiovascular risk consultation.
Main Results:
- At diagnosis, 60% of patients had risk factors, with 20% classified as high/very high risk by SCORE.
- During follow-up, hypertension was the main adverse event (23%).
- Significant improvements were observed: 66% quit smoking, 95% controlled blood pressure, 50% controlled diabetes, 76% managed weight, and 92% managed dyslipidemia. A reduction in SCORE was noted in a significant percentage of patients.
Conclusions:
- Follow-up in a specialized consultation is beneficial for managing cardiovascular risk factors in CML patients on TKI treatment.
- Proactive management of risk factors can reduce cardiovascular comorbidity and improve overall health outcomes for CML patients.
Abstract:
Introduction: Cardiovascular events are one of the main long-term complications in patients with chronic myeloid leukemia (CML) receiving treatment with tyrosine kinase inhibitors (TKIs). The proper choice of TKI and the adequate management of risk factors may reduce cardiovascular comorbidity in this population. Methods: This study evaluated the cardiovascular risk of a cohort of patients with CML at diagnosis and after follow-up in a specialized cardiovascular risk consultation. In order to do this, we performed data analysis from 35 patients who received TKIs and were referred to the aforementioned consultation between 2015 and 2018 at our center. Cardiovascular risk factors were analyzed separately, as well as integrated into the cardiovascular SCORE, both at diagnosis and at the last visit to the specialized consultation. Results: At the time of diagnosis, 60% had some type of risk factor, 20% had a high or very high risk SCORE, 40% had an intermediate risk, and 40% belonged to the low risk category. During follow-up, the main cardiovascular adverse event observed was hypertension (diagnosed in 8 patients, 23%). 66% of patients quit smoking, achieving control of blood pressure in 95%, diabetes in 50%, weight in 76%, and dyslipidemia in 92%. 5.7% of patients suffered a thrombotic event and a significant percentage of patients showed a reduction in their SCORE. Conclusion: Our study shows the benefit of controlling cardiovascular risk factors through follow-up in a specialized consultation for patients with CML treated with TKI.
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