Cardiovascular Risk in Essential Thrombocythemia and Polycythemia Vera: Thrombotic Risk and Survival
Vincenzo Accurso1, Marco Santoro2*, Salvatrice Mancuso1, Angelo Davide Contrino1, Paolo Casimiro1, Mariano Sardo1, Simona Raso2, Florinda Di Piazza3, Alessandro Perez3, Marco Bono3, Antonio Russo3 and Sergio Siragusa1.
Hematology Division University Hospital Policlinico "Paolo Giaccone",
Via del Vespro 129, 90127, Palermo, Italy, Via del Vespro 129, 90127,
2 Dept. of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
3 Department of Surgical, Oncological and Stomatological Disciplines, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Received: September 8, 2019
Accepted: December 16, 2019
Mediterr J Hematol Infect Dis 2020, 12(1): e2020008 DOI 10.4084/MJHID.2020.008
| This is an Open Access article distributed
under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
and bleeding events pose a severe risk for patients with Polycythemia
Vera (PV) and Essential Thrombocythemia (ET). Many factors can
contribute to promoting the thrombotic event due to the interaction
between platelets, leukocytes, and endothelium alterations. Moreover, a
significant role can be played by cardiovascular risk factors (CV.R)
such as cigarette smoking habits, hypertension, diabetes, obesity and
dyslipidemia. In this study, we evaluated the impact that CV.R plays on
thrombotic risk and survival in patients with PV and ET.
|Table 1. Characteristics of patients with ET and PV.|
|Table 2.Cardiovascular risk in 403 ET and PV patients.|
In patients with PV, we highlighted 49 (29.69%) cases of thrombosis at diagnosis or before diagnosis and 16 (9.69%) cases of thrombosis after diagnosis, while in patients with ET, respectively 49 (20.61%) and 17 cases (6.72%). Overall, PV patients show a thrombosis frequency of 39.39% if compared to 27.39% of ET patients (p = 0.014).
In patients with PV and ET, the frequency of thrombotic episodes is strictly correlated with cardiovascular risk factors; in fact, the frequency of thrombosis is much lower in patients without CVR. In ET patients without CVR, the thrombotic event is present in 10/59 cases if compared to patients with only one CVR factor (18/93) and to patients with more than one CVR factor (37/85). In PV patients, thrombosis is present, respectively, in 11/37 cases, 20/66 cases and 24/62 cases. Our data also show a significant correlation between cardiovascular risk factors and survival both in the cohort of patients with PV and ET, distinguished by the number of cardiovascular risk factors (see Figure 1).
|Figure 1. Survival and CVR factors in PV (A) and ET (B) patients.|
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