MYELOPROLIFERATIVE NEOPLASMS AND THROMBOSIS: A DANISH COHORT STUDY
(Abstract release date: 05/19/16)
EHA Library. Gade I. 06/09/16; 132896; E1347
Dr. Inger Lise Gade
Contributions
Contributions
Abstract
Abstract: E1347
Type: Eposter Presentation
Background
Arterial (AT) as well as venous thromboembolism (VTE) are causes of morbidity and mortality in patients with myeloproliferative neoplasms (MPN). Despite cytoreductive therapy and antiplatelet drugs MPN patients seem more prone to develop both AT and VTE than the background population. The influence of known cardiovascular risk factors on the risk of thrombosis in MPN patients is debated.
Aims
To investigate the absolute and relative risks of AT and VTE in MPN patients compared to matched controls in a prospective population based cohort study, adjusting for cardiovascular risk factors.
Methods
The Diet, Cancer and Health (DCH) Study is a Danish prospective population based cohort study enrolling 57.053 subjects between 1993-1997. Follow-up for this study was until 2008. Subjects were excluded if they had pre-baseline history of AT, VTE or cancer. Diagnosis of MPN was identified by linking to the Danish National Patient Registry, which provides information on date of diagnosis coded in the ICD-8 or ICD-10 system. All identified cases of VTE and AT, which in this study was either myocardial infarction (MI) or stroke, have been objectively confirmed by trained personnel looking through medical records or discharge letters, biochemical investigations and diagnostic images. Information on cardiovascular risk factors was obtained by self-administered questionnaires at baseline. Biometric measures were obtained by trained technicians at enrolment. For each MPN patients five participants matched on age and sex were identified in the DCH cohort. We used Cox regression models to estimate the relative risk of AT and VTE in MPN patients.
Results
During follow-up 72 women and 71 men were diagnosed with MPN, mean age was 56.8 years. Among MPN exposed subjects 10 MI’s, 6 cases of stroke and 3 VTE events were observed after MPN diagnosis, corresponding to incidence rates of 15.4 events per 1000 person years (10-3 p-y), 9.3*10-3 p-y and 4.4*10-3 p-y. In the Cox regression analysis MPN was associated with a significantly higher risk of MI, Hazard Ratio (HR) 5.7, 95% confidence interval (95%CI) 2.4-13.7. The HR for stroke among MPN exposed was 2.2, 95%CI 0.8-5.7. The observed VTE events resulted in a HR of 5.6, 95%CI 1.1-27.8 in the regression analysis. Our study was underpowered regarding the adjusted regression analysis. Table 1: Absolute and relative risks of thrombosis
Conclusion
In our prospective cohort study a 6-fold increased risk of MI was observed among MPN patients. The risk of stroke was increased by 2-fold, however not statistically significant. The risk of VTE was increased by 6-fold in MPN patients, however the number of events in this study was too few for adjusted analysis.
Session topic: E-poster
Keyword(s): Epidemiology, Myeloproliferative disorder, Thrombosis
Type: Eposter Presentation
Background
Arterial (AT) as well as venous thromboembolism (VTE) are causes of morbidity and mortality in patients with myeloproliferative neoplasms (MPN). Despite cytoreductive therapy and antiplatelet drugs MPN patients seem more prone to develop both AT and VTE than the background population. The influence of known cardiovascular risk factors on the risk of thrombosis in MPN patients is debated.
Aims
To investigate the absolute and relative risks of AT and VTE in MPN patients compared to matched controls in a prospective population based cohort study, adjusting for cardiovascular risk factors.
Methods
The Diet, Cancer and Health (DCH) Study is a Danish prospective population based cohort study enrolling 57.053 subjects between 1993-1997. Follow-up for this study was until 2008. Subjects were excluded if they had pre-baseline history of AT, VTE or cancer. Diagnosis of MPN was identified by linking to the Danish National Patient Registry, which provides information on date of diagnosis coded in the ICD-8 or ICD-10 system. All identified cases of VTE and AT, which in this study was either myocardial infarction (MI) or stroke, have been objectively confirmed by trained personnel looking through medical records or discharge letters, biochemical investigations and diagnostic images. Information on cardiovascular risk factors was obtained by self-administered questionnaires at baseline. Biometric measures were obtained by trained technicians at enrolment. For each MPN patients five participants matched on age and sex were identified in the DCH cohort. We used Cox regression models to estimate the relative risk of AT and VTE in MPN patients.
Results
During follow-up 72 women and 71 men were diagnosed with MPN, mean age was 56.8 years. Among MPN exposed subjects 10 MI’s, 6 cases of stroke and 3 VTE events were observed after MPN diagnosis, corresponding to incidence rates of 15.4 events per 1000 person years (10-3 p-y), 9.3*10-3 p-y and 4.4*10-3 p-y. In the Cox regression analysis MPN was associated with a significantly higher risk of MI, Hazard Ratio (HR) 5.7, 95% confidence interval (95%CI) 2.4-13.7. The HR for stroke among MPN exposed was 2.2, 95%CI 0.8-5.7. The observed VTE events resulted in a HR of 5.6, 95%CI 1.1-27.8 in the regression analysis. Our study was underpowered regarding the adjusted regression analysis. Table 1: Absolute and relative risks of thrombosis
| MI | Stroke | VTE | |
| MPN exposed (N= 143) | |||
| n | 10 | 6 | 3 |
| Incidence (*10-3 p-y), (95% CI) | 15.4 (8.3-28.6) | 9.3 (4.2-20.7) | 4.4 (1.4-13.7) |
| Matched controls (N= 715) | |||
| n | 10 | 15 | 3 |
| Incidence (*10-3 p-y), (95% CI) | 2.6 (1.4-4.8) | 4.0 (2.4-6.7) | 0.8 (0.3-2.4) |
| Relative risk of thrombosis | |||
| HR, (95% CI) | 5.7 (2.4-13.7) | 2.2 (0.8-5.7) | 5.6 (1.1-27.8) |
| p value | < 0.001 | 0.11 | 0.035 |
Conclusion
In our prospective cohort study a 6-fold increased risk of MI was observed among MPN patients. The risk of stroke was increased by 2-fold, however not statistically significant. The risk of VTE was increased by 6-fold in MPN patients, however the number of events in this study was too few for adjusted analysis.
Session topic: E-poster
Keyword(s): Epidemiology, Myeloproliferative disorder, Thrombosis
Abstract: E1347
Type: Eposter Presentation
Background
Arterial (AT) as well as venous thromboembolism (VTE) are causes of morbidity and mortality in patients with myeloproliferative neoplasms (MPN). Despite cytoreductive therapy and antiplatelet drugs MPN patients seem more prone to develop both AT and VTE than the background population. The influence of known cardiovascular risk factors on the risk of thrombosis in MPN patients is debated.
Aims
To investigate the absolute and relative risks of AT and VTE in MPN patients compared to matched controls in a prospective population based cohort study, adjusting for cardiovascular risk factors.
Methods
The Diet, Cancer and Health (DCH) Study is a Danish prospective population based cohort study enrolling 57.053 subjects between 1993-1997. Follow-up for this study was until 2008. Subjects were excluded if they had pre-baseline history of AT, VTE or cancer. Diagnosis of MPN was identified by linking to the Danish National Patient Registry, which provides information on date of diagnosis coded in the ICD-8 or ICD-10 system. All identified cases of VTE and AT, which in this study was either myocardial infarction (MI) or stroke, have been objectively confirmed by trained personnel looking through medical records or discharge letters, biochemical investigations and diagnostic images. Information on cardiovascular risk factors was obtained by self-administered questionnaires at baseline. Biometric measures were obtained by trained technicians at enrolment. For each MPN patients five participants matched on age and sex were identified in the DCH cohort. We used Cox regression models to estimate the relative risk of AT and VTE in MPN patients.
Results
During follow-up 72 women and 71 men were diagnosed with MPN, mean age was 56.8 years. Among MPN exposed subjects 10 MI’s, 6 cases of stroke and 3 VTE events were observed after MPN diagnosis, corresponding to incidence rates of 15.4 events per 1000 person years (10-3 p-y), 9.3*10-3 p-y and 4.4*10-3 p-y. In the Cox regression analysis MPN was associated with a significantly higher risk of MI, Hazard Ratio (HR) 5.7, 95% confidence interval (95%CI) 2.4-13.7. The HR for stroke among MPN exposed was 2.2, 95%CI 0.8-5.7. The observed VTE events resulted in a HR of 5.6, 95%CI 1.1-27.8 in the regression analysis. Our study was underpowered regarding the adjusted regression analysis. Table 1: Absolute and relative risks of thrombosis
Conclusion
In our prospective cohort study a 6-fold increased risk of MI was observed among MPN patients. The risk of stroke was increased by 2-fold, however not statistically significant. The risk of VTE was increased by 6-fold in MPN patients, however the number of events in this study was too few for adjusted analysis.
Session topic: E-poster
Keyword(s): Epidemiology, Myeloproliferative disorder, Thrombosis
Type: Eposter Presentation
Background
Arterial (AT) as well as venous thromboembolism (VTE) are causes of morbidity and mortality in patients with myeloproliferative neoplasms (MPN). Despite cytoreductive therapy and antiplatelet drugs MPN patients seem more prone to develop both AT and VTE than the background population. The influence of known cardiovascular risk factors on the risk of thrombosis in MPN patients is debated.
Aims
To investigate the absolute and relative risks of AT and VTE in MPN patients compared to matched controls in a prospective population based cohort study, adjusting for cardiovascular risk factors.
Methods
The Diet, Cancer and Health (DCH) Study is a Danish prospective population based cohort study enrolling 57.053 subjects between 1993-1997. Follow-up for this study was until 2008. Subjects were excluded if they had pre-baseline history of AT, VTE or cancer. Diagnosis of MPN was identified by linking to the Danish National Patient Registry, which provides information on date of diagnosis coded in the ICD-8 or ICD-10 system. All identified cases of VTE and AT, which in this study was either myocardial infarction (MI) or stroke, have been objectively confirmed by trained personnel looking through medical records or discharge letters, biochemical investigations and diagnostic images. Information on cardiovascular risk factors was obtained by self-administered questionnaires at baseline. Biometric measures were obtained by trained technicians at enrolment. For each MPN patients five participants matched on age and sex were identified in the DCH cohort. We used Cox regression models to estimate the relative risk of AT and VTE in MPN patients.
Results
During follow-up 72 women and 71 men were diagnosed with MPN, mean age was 56.8 years. Among MPN exposed subjects 10 MI’s, 6 cases of stroke and 3 VTE events were observed after MPN diagnosis, corresponding to incidence rates of 15.4 events per 1000 person years (10-3 p-y), 9.3*10-3 p-y and 4.4*10-3 p-y. In the Cox regression analysis MPN was associated with a significantly higher risk of MI, Hazard Ratio (HR) 5.7, 95% confidence interval (95%CI) 2.4-13.7. The HR for stroke among MPN exposed was 2.2, 95%CI 0.8-5.7. The observed VTE events resulted in a HR of 5.6, 95%CI 1.1-27.8 in the regression analysis. Our study was underpowered regarding the adjusted regression analysis. Table 1: Absolute and relative risks of thrombosis
| MI | Stroke | VTE | |
| MPN exposed (N= 143) | |||
| n | 10 | 6 | 3 |
| Incidence (*10-3 p-y), (95% CI) | 15.4 (8.3-28.6) | 9.3 (4.2-20.7) | 4.4 (1.4-13.7) |
| Matched controls (N= 715) | |||
| n | 10 | 15 | 3 |
| Incidence (*10-3 p-y), (95% CI) | 2.6 (1.4-4.8) | 4.0 (2.4-6.7) | 0.8 (0.3-2.4) |
| Relative risk of thrombosis | |||
| HR, (95% CI) | 5.7 (2.4-13.7) | 2.2 (0.8-5.7) | 5.6 (1.1-27.8) |
| p value | < 0.001 | 0.11 | 0.035 |
Conclusion
In our prospective cohort study a 6-fold increased risk of MI was observed among MPN patients. The risk of stroke was increased by 2-fold, however not statistically significant. The risk of VTE was increased by 6-fold in MPN patients, however the number of events in this study was too few for adjusted analysis.
Session topic: E-poster
Keyword(s): Epidemiology, Myeloproliferative disorder, Thrombosis
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