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Pulmonary Arterial Hypertension in Hospitalized Patients With Polycythemia Vera (from the National Inpatient Database)

•Patients with polycythemia vera have an increased prevalence of PAH.•Polycythemia vera is an independent predictor of PAH.•Patients with P. vera and PAH have an increased risk for in-hospital mortality.The prevalence and pathophysiology of pulmonary arterial hypertension (PAH) in myeloproliferative...

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Published in:The American journal of cardiology 2021-03, Vol.143, p.154-157
Main Authors: Stempel, Jessica M., Gopalakrishnan, Akshaya, Krishnamoorthy, Parasuram, Lo, Kevin Bryan, Mittal, Varun, Moghbeli, Nazanin, Varadi, Gabor, Rangaswami, Janani
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description •Patients with polycythemia vera have an increased prevalence of PAH.•Polycythemia vera is an independent predictor of PAH.•Patients with P. vera and PAH have an increased risk for in-hospital mortality.The prevalence and pathophysiology of pulmonary arterial hypertension (PAH) in myeloproliferative neoplasms are poorly understood and have not been evaluated on larger scale studies. These reports generally focus on all myeloproliferative neoplasms rather than each disease individually. We aim to establish the prevalence and association of PAH in patients with polycythemia vera (P. vera) using the Nationwide Inpatient Sample database. We identified 38,395 patients with a discharge diagnosis of P. vera and 39,395,521 patients without P. vera. Both groups were queried for a concomitant discharge diagnosis of PAH. Unadjusted and multivariate adjusted logistic regression analyses were performed to determine if presence of P. vera predicted PAH after adjusting for clinically relevant risk factors. The prevalence of P. vera was 0.1% of all hospital discharge records. Pulmonary arterial hypertension was more prevalent in patients with P. vera compared with the control population (7.9% vs 1.9%, p
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These reports generally focus on all myeloproliferative neoplasms rather than each disease individually. We aim to establish the prevalence and association of PAH in patients with polycythemia vera (P. vera) using the Nationwide Inpatient Sample database. We identified 38,395 patients with a discharge diagnosis of P. vera and 39,395,521 patients without P. vera. Both groups were queried for a concomitant discharge diagnosis of PAH. Unadjusted and multivariate adjusted logistic regression analyses were performed to determine if presence of P. vera predicted PAH after adjusting for clinically relevant risk factors. The prevalence of P. vera was 0.1% of all hospital discharge records. Pulmonary arterial hypertension was more prevalent in patients with P. vera compared with the control population (7.9% vs 1.9%, p &lt;0.0001). Presence of P. vera was a determinant of PAH in unadjusted analysis (odds ratio 4.4 [4.1 to 4.8]; p &lt;0.001). After adjusting for age, gender, race, diabetes, tobacco use, previous history of tumor, previous history of pulmonary embolism, chronic lung disease, and chronic kidney disease, P. vera was associated with nearly a 3-fold higher risk for PAH after adjusting for several risk factors (2.98 [2.7 to 3.2], p &lt;0.001).</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2020.12.023</identifier><identifier>PMID: 33347839</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Distribution ; Aged ; Blood cancer ; Cardiovascular diseases ; Chronic illnesses ; Congestive heart failure ; Coronary artery disease ; Cytokines ; Diabetes ; Endothelium ; Female ; Heart diseases ; Hemodynamics ; Hospital Mortality ; Hospitalization ; Humans ; Hypertension ; Kidney diseases ; Kinases ; Logistic Models ; Lung diseases ; Male ; Microenvironments ; Middle Aged ; Mortality ; Multivariate Analysis ; Odds Ratio ; Patients ; Polycythemia ; Polycythemia vera ; Polycythemia Vera - epidemiology ; Population ; Prevalence ; Pulmonary Arterial Hypertension - epidemiology ; Pulmonary embolisms ; Pulmonary hypertension ; Quality of life ; Risk analysis ; Risk Factors ; Sex Distribution ; Sickle cell disease ; Thromboembolism ; Tobacco ; United States - epidemiology</subject><ispartof>The American journal of cardiology, 2021-03, Vol.143, p.154-157</ispartof><rights>2020 Elsevier Inc.</rights><rights>2020. 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These reports generally focus on all myeloproliferative neoplasms rather than each disease individually. We aim to establish the prevalence and association of PAH in patients with polycythemia vera (P. vera) using the Nationwide Inpatient Sample database. We identified 38,395 patients with a discharge diagnosis of P. vera and 39,395,521 patients without P. vera. Both groups were queried for a concomitant discharge diagnosis of PAH. Unadjusted and multivariate adjusted logistic regression analyses were performed to determine if presence of P. vera predicted PAH after adjusting for clinically relevant risk factors. The prevalence of P. vera was 0.1% of all hospital discharge records. Pulmonary arterial hypertension was more prevalent in patients with P. vera compared with the control population (7.9% vs 1.9%, p &lt;0.0001). Presence of P. vera was a determinant of PAH in unadjusted analysis (odds ratio 4.4 [4.1 to 4.8]; p &lt;0.001). 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These reports generally focus on all myeloproliferative neoplasms rather than each disease individually. We aim to establish the prevalence and association of PAH in patients with polycythemia vera (P. vera) using the Nationwide Inpatient Sample database. We identified 38,395 patients with a discharge diagnosis of P. vera and 39,395,521 patients without P. vera. Both groups were queried for a concomitant discharge diagnosis of PAH. Unadjusted and multivariate adjusted logistic regression analyses were performed to determine if presence of P. vera predicted PAH after adjusting for clinically relevant risk factors. The prevalence of P. vera was 0.1% of all hospital discharge records. Pulmonary arterial hypertension was more prevalent in patients with P. vera compared with the control population (7.9% vs 1.9%, p &lt;0.0001). Presence of P. vera was a determinant of PAH in unadjusted analysis (odds ratio 4.4 [4.1 to 4.8]; p &lt;0.001). After adjusting for age, gender, race, diabetes, tobacco use, previous history of tumor, previous history of pulmonary embolism, chronic lung disease, and chronic kidney disease, P. vera was associated with nearly a 3-fold higher risk for PAH after adjusting for several risk factors (2.98 [2.7 to 3.2], p &lt;0.001).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33347839</pmid><doi>10.1016/j.amjcard.2020.12.023</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0001-9162-0579</orcidid><orcidid>https://orcid.org/0000-0001-7088-6677</orcidid><orcidid>https://orcid.org/0000-0001-6099-2142</orcidid><orcidid>https://orcid.org/0000-0001-7117-6677</orcidid></addata></record>
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subjects Age Distribution
Aged
Blood cancer
Cardiovascular diseases
Chronic illnesses
Congestive heart failure
Coronary artery disease
Cytokines
Diabetes
Endothelium
Female
Heart diseases
Hemodynamics
Hospital Mortality
Hospitalization
Humans
Hypertension
Kidney diseases
Kinases
Logistic Models
Lung diseases
Male
Microenvironments
Middle Aged
Mortality
Multivariate Analysis
Odds Ratio
Patients
Polycythemia
Polycythemia vera
Polycythemia Vera - epidemiology
Population
Prevalence
Pulmonary Arterial Hypertension - epidemiology
Pulmonary embolisms
Pulmonary hypertension
Quality of life
Risk analysis
Risk Factors
Sex Distribution
Sickle cell disease
Thromboembolism
Tobacco
United States - epidemiology
title Pulmonary Arterial Hypertension in Hospitalized Patients With Polycythemia Vera (from the National Inpatient Database)
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