Contribution of cardiovascular risk factors in the thrombotic complications of essential thrombocythaemia: a Hungarian single-institute retrospective analysis.

OBJECTIVE: Essential thrombocythaemia (ET) is a myeloproliferative neoplasm in which there is an increased risk of thrombotic complications. The conventional thrombosis risk assessment of these patients is based on an age over 60 and a history of thrombosis. The aim of this report is to analyse the contribution of cardiovascular risk (CV) factors as possible additional thrombotic risk factors in the thrombotic complications seen in ET. PATIENTS AND METHODS: One hundred and one ET patients (72 females and 29 males with a median age of 61 years) were enrolled between 1999 and 2011. Mann-Whitney and multivariate binary logistic regression tests were performed. The Kaplan-Meier method followed by the log-rank test was used to evaluate the probability of thrombosis-free survival. RESULTS: The presence of one or two or more CV risk factors significantly increased the risk of thrombosis. Separately, the contribution of high blood pressure and hyperlipidaemia proved to be influential, whereas tobacco use, diabetes mellitus and obesity were not significant. Significant differences were revealed in the probability of thrombosis-free survival between patients without CV risk factors and those with at least one CV risk factor, and between those with at most one CV risk factor and those with two or more CV risk factors. CONCLUSIONS: On the basis of the results on the current cohort, it is suggested that CV risk factors may influence the thrombotic complications in ET.

Thrombosis and risk factors in female patients with a rare acquired thrombophilia: chronic myeloproliferative disorder - polycythaemia vera and essential thrombocythaemia.

OBJECTIVE: In polycythaemia vera (PV) and essential thrombocythaemia (ET), the life expectancy of the patients is greatly affected by thrombotic events. An investigation was performed of the potential association of PV/ET, and thrombotic complications with cardiovascular (CV) risk factors, a leukocyte count at the haematological diagnosis > 11.1 G/L, and the JAK2V617F mutation. PATIENTS AND METHODS: In the period 1998-2011, 128 women with a median age of 62 years were enrolled. RESULTS: The risk of thrombotic events before the diagnosis was 32.8% (42/128), while in the follow-up period it was 10.2% (13/128). The difference in the probability of thrombosis-free survival between those with at most one CV risk factor and those with two or more CV risk factors was significant (p = 0.005). The presence of two or more CV risk factors (univariate: p = 0.011; multivariate: relative risk: 4.728, 95% CI 1.312-17.040; p = 0.018) significantly increased the risk of thrombosis. Univariate analyses revealed that high blood pressure (p = 0.001), hyperlipidaemia (p = 0.005) and cigarette smoking (p = 0.051) were associated with a significantly higher risk of thrombosis. Analyses of the influence of the leukocyte count (univariate: p = 0.424; multivariate: relative risk: 1.407, 95% CI 0.359-5.507; p = 0.624) and the JAK2V617F mutation (univariate: p = 0.367; multivariate: relative risk: 1.428, 95% CI 0.316-6.460; p = 0.643) on subsequent thrombotic complications resulted in a non-signicant tendency. CONCLUSIONS: Female patients who display CV risk factors (high blood pressure, hyperlipidaemia and/or cigarette smoking) and PV or ET may well be at a higher risk of thrombotic events and require special consideration as concerns as the prevention and management of thrombotic events.