Abstract 10079: Risk of Cardiovascular and All-Cause Mortality in Patients with Myeloproliferative Neoplasms Following Heart Failure Hospitalization

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-11, Vol.144 (Suppl_1), p.A10079-A10079
• Main Authors: Leiva, Orly, Bhatt, Ankeet, Jenkins, Andrew, Rosovsky, Rachel, Karp-Leaf, Rebecca, Goodarzi, Katayoon, Hobbs, Gabriela
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.10079

IntroductionMyeloproliferative neoplasms (MPNs), polycythemia vera (PV), essential thrombocytosis (ET) and myelofibrosis (MF), are clonal stem cell neoplasms that commonly harbor the JAK2V617F mutation. Recent preclinical studies suggest that the JAK2V617F mutation in hematopoietic stem cells accelerates pathologic cardiac remodeling, potentially contributing to HF. However, the prognostic significance of HF hospitalization in MPNs has not been studied. MethodsSingle-center, retrospective cohort study of patients with MPN with ≥ 1 HF hospitalization after MPN diagnosis from 2000-2020 (N = 105, 39 ET, 39 PV, 27 MF). Our outcomes were death (cardiovascular [CV] and all-cause mortality [ACM]) and recurrent HF hospitalization after index hospitalization. To assess predictors of CV death and ACM, we used a multivariable logistic regression using age, sex, LVEF ≥ 50% at index event, cardiology follow-up 3 months after index, pulmonary hypertension (PH) before index, MF, treatment of MPN, NT-proBNP at index, CAD, hypertension, prior stroke, diabetes, and arterial thrombosis (AT) after index (stroke or MI) as co-variables. ResultsAfter median follow-up time of 19 months (IQR 5, 19, full characteristics in Table), CV death, ACM, recurrent HF, AT occurred in 30%, 55%, 54%, 12%, respectively. After multivariable regression, recurrent HF (aOR 5.3, 95% CI 1.7-19.3), PH (aOR 3.2, 95% CI 1.0-10.7) and AT (aOR 4.4, 95% CI 1.1-21.5) were associated with increased odds of CV death. Close cardiologist follow-up (aOR 0.2, 95% CI 0.05-0.7) and LVEF ≥ 50% (aOR 0.3, 95% CI 0.1-0.9) were associated with decreased odds of CV death. Only recurrent HF was associated with increased odds of ACM (aOR 2.5, 95% CI 1.0-6.5). ConclusionsPatients with MPN who have multiple HF hospitalizations have high rates of CV death and ACM. Closer cardiology follow-up pre and post HF hospitalization may improve outcomes in this population and more research is needed to improve cardiovascular outcomes.