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Major cardiovascular events in long-term multiple myeloma survivors: a Korean case-control study (the CAREMM-2105
Jeonghoon Ha1, Suein Choi2,3, Seulji Moon2,3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
Insights
Long-term multiple myeloma (MM) survivors show lower cardiovascular disease (CVD) risk overall, but younger patients require vigilant CVD monitoring. Early detection and personalized interventions are crucial for this population.
Area of Science:
- Oncology
- Cardiology
- Epidemiology
Background:
- Multiple myeloma (MM) survival rates have improved, yet long-term cardiovascular outcomes for survivors are not well-documented.
- Understanding the cardiovascular risks in MM survivors is essential for comprehensive cancer survivorship care.
Purpose of the Study:
- To compare the incidence of cardiovascular disease (CVD) between long-term multiple myeloma (MM) survivors and a matched control group.
- To identify specific risk factors and patient subgroups within the MM survivor population at higher risk for CVD.
Main Methods:
- A retrospective case-control study using the Korean National Health Insurance Service database (2009-2020).
- 15,402 MM patients were propensity score matched with 15,402 controls based on birth year and sex.
- Comparison of cumulative incidence of cardiovascular events and CVD risk over 8-year follow-up.
Main Results:
- Long-term MM survivors exhibited a significantly lower cumulative incidence of cardiovascular events (12.5% vs. 22.1%) and overall CVD risk by 8-year follow-up compared to controls.
- A 5-year landmark analysis showed a lower CVD incidence in MM patients (7.8%) versus controls (9.8%).
- Patients aged under 50 years at initial MM diagnosis demonstrated a significantly higher CVD risk compared to older MM patients and controls.
Conclusions:
- Vigilant cardiovascular disease monitoring is necessary for all long-term multiple myeloma survivors.
- Younger MM survivors (diagnosed before age 50) require particular attention due to their elevated CVD risk.
- Integrating cardiovascular risk management into long-term care plans for MM survivors, with a focus on personalized interventions for younger patients, is crucial.
Purpose:
Despite improvements in multiple myeloma (MM) survival rates, data on cardiovascular outcomes in long-term survivors remain lacking.
Methods:
This retrospective case-control study utilized the Korean National Health Insurance Service database (2009-2020) to compare the incidence of cardiovascular disease (CVD) between patients with MM and a matched control group, focusing on long-term (> 5 years) survivors. A preliminary case cohort (n = 15,402 patients with MM) and a matched control cohort (n = 123,216 patients without MM) were established based on birth year and sex. Following 1:1 propensity score matching, the final matched cohorts each comprised 15,402 participants.
Results:
The case and control cohorts were comparable in mean age (66.2 ± 11.5 years vs. 66.1 ± 11.3 years), sex, age distribution, and comorbidities. By the 8-year follow-up, the cumulative incidence of CV events (12.5% vs. 22.1%) and CVD risk were significantly lower in the case cohort. The 5-year landmark analysis revealed significant differences in CVD incidence between the cohorts (7.8% [case cohort] vs. 9.8% [control cohort]), with variations across age groups and sex, highlighting a significantly higher CVD risk among patients aged < 50 years in the case cohort (P < 0.001).
Conclusions:
These findings underscore the need for vigilant CVD monitoring in MM long-term survivors, particularly those aged < 50 years at first diagnosis.
Implication For Cancer Survivors:
This study highlights the importance of integrating cardiovascular monitoring and risk management into long-term care for MM survivors, with a focus on younger patients and personalized interventions.
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