Ph myeloproliferative neoplasms and the related risk factors for stroke occurrence: Results from a registry of patients treated with Anagrelide

Abstract

Arterial thrombosis is a common complication in patients with Ph myeloproliferative neoplasms (MPN). We searched for the risk factors of stroke in MPN patients from anagrelide registry. We analyzed the potential risk factors triggering a stroke/TIA event in 249 MPN patients with previous stroke (n = 168) or Transient Ischemic Attack (TIA) (n = 140), and in 1,193 MPN control subjects (without clinical history of thrombosis). These patients were registered in a prospective manner, providing a follow-up period after Anagrelide treatment. The median age of the patients in the experimental group was of 56 years of age (ranging from 34–76) and of 53 years of age (ranging from 26–74) in the control group (p < 0.001). Using a multivariate model, we determined the following as risk factors: JAK2V617F mutation (OR 2.106, 1.458–3.043, p = 0.006), age (OR 1.017/year, 1.005–1,029, p = 0.006), male gender (OR 1.419, 1.057–1.903, p = 0.020), MPN diagnosis (OR for PMF 0.649, 0.446–0.944, p = 0.024), BMI (OR 0.687 for BMI > 25, 0.473–0.999, p = 0.05) and high TAG levels (OR 1.734, 1.162–2.586, p = 0.008), all of which were statistically significant for CMP development. Concerning the risk factors for thrombophilia, only the antiphospholipid syndrome (OR 1.994, 1.017–3.91, p = 0.048) was noteworthy in a stroke-relevant context. There was no significant difference between the blood count of the patients prior to a stroke event and the control group, both of which were under a cytoreductive treatment. We found that age, male gender, JAK2V617F mutation, previous venous thrombosis, and hypertriglyceridemia represent independent risk factors for the occurrence of a stroke in Ph MPN patients.

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CZEMP organisation.

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Acknowledgements

This work was supported by grants MH CZ—DRO (UHHK, 00179906) and PROGRES Q40/08.

Funding

Supported by MH CZ- DRO (UHHK, 00179906) and PROGRES Q40/08.

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Contributions

All authors, except MK and PO, contributed to this Registry with the highest numbers of patients. JS, MP, PD, and PO designed the study. PO performed the statistical analyses. MK and PO wrote the manuscript, and PD made the final corrections.

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Correspondence to Milan Košťál.

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Conflict of interest

MK receives a speaker ‘s honoraria from Novartis, AOP Orphan Pharmaceuticals. JS has received speaker ‘s and consultancy honoraria from AOP Orphan Pharmaceuticals. MP receives speaker ‘s and consultancy honoraria from AOP Orphan Pharmaceuticals AG and Novartis. PD receives speaker’s and consultancy honoraria from AOP Orphan Pharmaceuticals. P.O. has no conflict of interests.

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Košťál, M., Schwarz, J., Ovesná, P. et al. Ph myeloproliferative neoplasms and the related risk factors for stroke occurrence: Results from a registry of patients treated with Anagrelide. J Thromb Thrombolysis (2020). https://doi.org/10.1007/s11239-020-02175-8

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Keywords

  • Stroke
  • TIA
  • Myeloproliferation
  • Thrombosis
  • Risk factor
  • JAK2