Predictors of cardiovascular events and all‐cause of death in patients with transfusion‐dependent myelodysplastic syndrome
| Autor: | Tamara Jimenez-Solas, Agustín C. Martín-García, Teresa Gonzalez-Martinez, Elena Díaz-Peláez, Marta Alonso-Fernández-Gatta, Ana Martín-García, Félix López-Cadenas, Pedro L. Sánchez, María Díez-Campelo, Clara Sanchez-Pablo |
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| Přispěvatelé: | Junta de Castilla y León, Instituto de Salud Carlos III |
| Rok vydání: | 2021 |
| Předmět: |
Male
Risk medicine.medical_specialty Iron Overload Multivariate analysis Heart disease Population Kaplan-Meier Estimate Disease 03 medical and health sciences 0302 clinical medicine Cause of Death Internal medicine Humans Medicine Blood Transfusion Prospective Studies education Prospective cohort study Pathological Aged Cause of death Aged 80 and over education.field_of_study business.industry Hematology Middle Aged T1 mapping Prognosis Cardiovascular disease medicine.disease Magnetic Resonance Imaging Log-rank test Feature tracking Cardiovascular Diseases NT-proBNP Myelodysplastic Syndromes 030220 oncology & carcinogenesis Cardiology Female business Myelodysplastic syndrome Biomarkers Follow-Up Studies 030215 immunology |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/bjh.17652 |
| Popis: | Cardiovascular disease (CVD) involves the second cause of death in low-risk myelodysplastic syndrome (MDS) population. Prospective study to characterise the CVD and to identify predictors for the combined event (CE) cardiovascular event and/or all-cause mortality in transfusion dependent low-risk MDS patients. Thirty-one patients underwent a cardiac assessment including biomarkers and cardiac magnetic resonance (cMR) with parametric sequences (T1, T2 and T2* mapping) and myocardial deformation by feature tracking (FT) and were analysed for clonal hematopoiesis of indeterminate potential mutations. Cardiac assessment revealed high prevalence of unknown structural heart disease (51% cMR pathological findings). After 2·2 [0·44] years follow-up, 35·5% of patients suffered the CE: 16% death, 29% cardiovascular event. At multivariate analysis elevated NT-proBNP ≥ 486pg/ml (HR 96·7; 95%-CI 1·135–8243; P = 0·044), reduced native T1 time < 983ms (HR 44·8; 95%-CI 1·235–1623; P = 0·038) and higher left ventricular global longitudinal strain (LV-GLS) (HR 0·4; 95%-CI 0·196–0·973; P = 0·043) showed an independent prognostic value. These variables, together with the myocardial T2* time < 20ms, showed an additive prognostic value (Log Rank: 12·4; P = 0·001). In conclusion, low-risk MDS patients frequently suffer CVD. NT-proBNP value, native T1 relaxation time and longitudinal strain by FT are independent predictors of poor cardiovascular prognosis, thus, their determination would identify high-risk patients who could benefit from a cardiac treatment and follow-up. This work was funded by aGerencia Regional de Salud de Castilla y León grant(GRS1203/A/15) and a Rıo Hortega contract (CM19/00055),supported by the Instituto de Salud Carlos III in Spain (co-funded by the European Social Fund ‘Investing in yourfuture’). |
| Databáze: | OpenAIRE |
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