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Myeloproliferative Neoplasms and Cardiovascular Disease: A Review
Orly Leiva1,2, Olivia Liu3, Sophia Zhou3
1Department of Medicine, Division of Cardiology, New York University Grossman School of Medicine, New York, NY, USA. orly.leiva@uchicagomedicine.org.
Insights
Myeloproliferative neoplasms (MPN) increase cardiovascular disease (CVD) risk, including thrombotic events and non-thrombotic conditions like heart failure. Further research is needed to optimize CVD prevention and management in MPN patients.
Area of Science:
- Hematology
- Cardiology
- Oncology
Background:
- Myeloproliferative neoplasms (MPN) are clonal hematopoietic stem cell disorders driven by JAK/STAT pathway activation.
- Cardiovascular disease (CVD) is a major cause of morbidity and mortality in MPN patients.
- MPNs are associated with both thrombotic and non-thrombotic cardiovascular complications.
Purpose of the Study:
- To review the spectrum of cardiovascular complications in MPN.
- To highlight the need for improved CVD prevention strategies in MPN.
- To raise clinician awareness of MPN-associated cardiovascular risks.
Main Methods:
- Literature review of recent studies on MPN and CVD outcomes.
- Analysis of cardiovascular complications including acute myocardial infarction, heart failure, atrial fibrillation, and pulmonary hypertension.
- Discussion of current understanding and gaps in CVD prevention for MPN patients.
Main Results:
- MPN patients face significant risks for various CVDs, including thrombotic events, heart failure, arrhythmias, and pulmonary hypertension.
- Specific outcomes for acute myocardial infarction, heart failure, atrial fibrillation, and pulmonary hypertension in MPN patients have been characterized.
- Optimal strategies for cardiovascular disease prevention in MPN are not yet established.
Conclusions:
- Clinicians must recognize the broad range of cardiovascular complications in MPN, encompassing thrombotic and non-thrombotic conditions.
- Further research is essential to enhance cardiovascular outcomes for individuals with MPN.
- Awareness and proactive management of CVD are crucial for improving the prognosis of MPN patients.
Opinion Statement:
Myeloproliferative neoplasms (MPN) are a heterogenous group of disorders of clonal hematopoiesis characterized by constitutive activation of the JAK/STAT signaling pathway leading to proliferation of blood cells. Cardiovascular disease (CVD) contributes significantly to the morbidity and mortality of patients with MPN. Particularly well-known CVD complications of MPNs are arterial and venous thrombotic events. However, MPNs are also associated with other forms of CVD including atrial fibrillation, heart failure, and pulmonary hypertension. Recent studies have characterized outcomes of patients with MPN and CVD, including acute myocardial infarction (AMI), heart failure, atrial fibrillation, and pulmonary hypertension. Additionally, optimal cardiovascular disease prevention strategies in patients with MPN are not yet clear. Further investigation is warranted to improve CVD outcomes in patients with MPN. Clinicians should be aware of cardiovascular complications of MPN, including thrombotic as well as non-thrombotic complications (heart failure, arrhythmias, pulmonary hypertension).
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