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.

PubMed

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.

Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
13
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
16
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
13
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
13
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
12
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
13