OP340 Adverse Clinical Events And Associated Risk Factors In Patients With Very-High-Risk Atherosclerotic Cardiovascular Disease

2020 ◽  
Vol 36 (S1) ◽  
pp. 6-6
Author(s):  
Boya Zhao ◽  
Xiaoning He ◽  
Jia Zhao ◽  
Jing Wu
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
High Risk ◽  
Atherosclerotic Cardiovascular Disease ◽  
Clinical Events ◽  
History Of ◽  
Associated Risk Factors ◽  
Very High

IntroductionClinical atherosclerotic cardiovascular disease (ASCVD) patients are judged to be very-high-risk if they had a history of multiple major ASCVD events, or one major ASCVD event with multiple high-risk conditions. Very-high-risk ASCVD patients are under high risk of adverse clinical events and need more attention in the management of secondary prevention. This real-world study aimed at estimating the prevalence of very-high-risk ASCVD and investigating the occurrence of adverse clinical events and associated risk factors among patients with very-high-risk ASCVD in China.MethodsData were obtained from the Urban Employee Basic Medical Insurance database in Tianjin, China. Very-high-risk ASCVD patients were identified from 2014 to 2015 through the history of ASCVD events and evidence of high-risk conditions, and followed for 24 months. Adverse clinical events were measured by major adverse cardiovascular events (MACE), a composite endpoint of stroke, myocardial infarction (MI) and death. A Cox regression model was used to identify risk factors of MACE, adjusting for potential confounders.ResultsThe percentage of clinical ASCVD patients identified as very-high-risk was 35.2 (N = 41,181), while 34,740 patients with continuous enrollment were included (mean age: 67.1 years; 42.5% female). The percentage of patients who had MACE in the 24-month follow-up period was 27.7, with stroke (22.3%) as the most prevalent event followed by death (6.9%) and MI (1.3%). Male gender, older age, and having MI or ischemic stroke (versus unstable angina) as the index major ASCVD event were risk predictors of MACE.ConclusionsMore than one-third of patients with clinical ASCVD are under very-high-risk in China, and among them 27.7 percent experience MACE during a 24-month follow-up period. Male patients, older patients, and patients who had MI or ischemic stroke are under higher risk of experiencing MACE. Future studies are warranted for comparing the differences in characteristics, pattern of drug use, occurrence of adverse clinical events and medical burden between very-high-risk ASCVD patients and ASCVD patients not at very-high-risk.

Abstract P019: A Single Model For Predicting Major Adverse Cardiovascular Events In Individuals With And Without History Of Atherosclerotic Cardiovascular Disease: The Atherosclerosis Risk In Communities (aric) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yejin Mok ◽  
Lena Mathews ◽  
Ron C Hoogeveen ◽  
Michael J Blaha ◽  
Christie M Ballantyne ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Stratification ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Atherosclerotic Cardiovascular Disease ◽  
Single Model ◽  
History Of ◽  
Very High

Background: In the 2018 AHA/ACC Cholesterol guideline, risk stratification is an essential element. The use of a Pooled Cohort Equation (PCE) is recommended for individuals without atherosclerotic cardiovascular disease (ASCVD), and the new dichotomous classification of very high-risk vs. high-risk has been introduced for patients with ASCVD. These distinct risk stratification systems mainly rely on traditional risk factors, raising the possibility that a single model can predict major adverse cardiovascular events (MACEs) in persons with and without ASCVD. Methods: We studied 11,335 ARIC participants with (n=885) and without (n=10,450) a history of ASCVD (myocardial infarction, ischemic stroke, and symptomatic peripheral artery disease) at baseline (1996-98). We modeled factors in the PCE and the new classification for ASCVD patients (Figure legend) in a single CVD prediction model. We examined their associations with MACEs (myocardial infarction, stroke, and heart failure) using Cox models and evaluated the discrimination and calibration for a single model including those factors. Results: During a median follow-up of 18.4 years, there were 3,658 MACEs (3,105 in participants without ASCVD). In general, the factors in the PCE and the risk classification system for ASCVD patients were associated similarly with MACEs regardless of baseline ASCVD status, although age and systolic blood pressure showed significant interactions. A single model with these predictors and the relevant interaction terms showed good calibration and discrimination for those with and without ASCVD (c-statistic=0.729 and 0.704, respectively) (Figure). Conclusion: A single CVD prediction model performed well in persons with and without ASCVD. This approach will provide a specific predicted risk to ASCVD patients (instead of dichotomy of very high vs. high risk) and eliminate a practice gap between primary vs. secondary prevention due to different risk prediction tools.

Self-Reported Cardiac Risk Factors in Emergency Department Nurses and Paramedics

2000 ◽  
Vol 15 (2) ◽  
pp. 14-17 ◽  
Author(s):  
Tyler W. Barrett ◽  
Valerie C. Norton ◽  
Matthew Busam ◽  
Julie Boyd ◽  
David J. Maron ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Emergency Department ◽  
High Risk ◽  
Cardiac Disease ◽  
Cardiac Risk ◽  
Smoking History ◽  
Cardiac Risk Factors ◽  
History Of ◽  
Very High

AbstractStudy Objective:Our objective was to assess the prevalence of cardiac risk factors in a sample of urban paramedics and emergency department (ED) nurses.Methods:We asked 175 paramedics and ED nurses working at a busy, urban ED to complete a cardiovascular risk assessment. The survey asked subjects to report smoking history, diet, exercise habits, weight, stress levels, medication use, history of hypertension or cardiac disease, family history of cardiovascular disease (CVD), and cholesterol level (if known)Results:129 of 175 surveys were returned (74% return rate) by 85 paramedics and 44 nurses. The percentages of paramedics and nurses at high or very high risk for cardiac disease were 48% and 41%, respectively. Forty-one percent of female respondents and 46% of male respondents were at high or very high risk. Cigarette smoking was reported in 19% of the paramedics and 14% of the nurses. The percentages of paramedics and nurses who reported hypertension were 13% and 11%, respectively. High cholesterol was reported in 31% of paramedics and 16% of nurses.Conclusions:Forty-eight percent of paramedics and 41% of ED nurses at this center are at high or very high risk for cardiovascular disease, by self-report. Efforts should be made to better educate and intervene in this population of health-care providers in order to reduce their cardiac risk.

Determinants of Incident Atherosclerotic Cardiovascular Disease Events Among Those With Absent Coronary Artery Calcium: Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2021 ◽  
Author(s):  
Mahmoud Al−Rifai ◽  
Michael J. Blaha ◽  
Vijay Nambi ◽  
Steven J.C. Shea ◽  
Erin D. Michos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cigarette Smoking ◽  
Atherosclerotic Cardiovascular Disease ◽  
Current Cigarette Smoking ◽  
Current Cigarette ◽  
History Of

Background : The 2018 American Heart Association/ American College of Cardiology Multisociety (AHA/ACC/MS) cholesterol guideline states that statin therapy may be withheld or delayed among intermediate risk individuals in the absence of coronary artery calcium (CAC=0). We evaluated whether traditional cardiovascular risk factors are associated with incident atherosclerotic cardiovascular disease (ASCVD) events among individuals with CAC=0 over long−term follow−up. Methods : We included participants with CAC=0 at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of individuals free of clinical ASCVD at baseline. We used multivariable-adjusted Cox proportional hazards models to study the association between cardiovascular risk factors [cigarette smoking, diabetes mellitus, hypertension, preventive medication use (aspirin and statin), family history of premature ASCVD, chronic kidney disease, waist circumference, lipid and inflammatory markers] and adjudicated incident ASCVD outcomes. Results : We studied 3,416 individuals (mean (SD) age 58 (9) years; 63% were female, 33% White, 31% Black, 12% Chinese-American, and 24% Hispanic. Over a median follow-up of 16 years, there were 189 ASCVD events (composite of CHD and stroke) of which 91 were CHD, 88 were stroke, and 10 were both CHD and stroke events. The unadjusted event rates of ASCVD were ≤5 per 1000−person−years among individuals with CAC=0 for most risk factors with the exception of current cigarette smoking (7.3), diabetes mellitus (8.9), hypertension (5.4), and chronic kidney disease (6.8). After multivariable-adjustment, risk factors that were significantly associated with ASCVD: hazard ratio (HR) 95% confidence interval (CI) included current cigarette smoking: 2.12 (1.32,3.42), diabetes mellitus: 1.68 (1.01,2.80), and hypertension: 1.57 (1.06,2.33). Conclusions : Current cigarette smoking, diabetes mellitus, and hypertension are independently associated with incident ASCVD over 16-year follow-up among those with CAC=0. Family history of premature ASCVD may be associated with ASCVD risk among women only.

Abstract 55: Kidney Measures Beyond Conventional Risk Factors for Predicting Incident Cardiovascular Disease: A Collaborative Meta-Analysis of 16 Cohorts

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Josef Coresh ◽  
Yingying Sang ◽  
John Chalmers ◽  
Caroline Fox ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
General Population ◽  
Meta Analysis ◽  
Cvd Risk ◽  
History Of ◽  
Conventional Risk Factors ◽  
Cvd Mortality

Introduction: Despite the high risk of cardiovascular disease (CVD) in those with chronic kidney disease (CKD), there are conflicting data as to whether two key kidney measures, estimated glomerular filtration rate (eGFR) and albuminuria, contribute to better CVD prediction, beyond conventional risk factors, warranting a more comprehensive investigation over a broad range of populations. Methods: We studied 127,825 participants without history of CVD from 12 general population, 3 high risk and 1 CKD cohorts with data on eGFR (based on the CKD-EPI creatinine equation) and urinary albumin-creatinine ratio (ACR) and at least 4 years of median follow-up for CVD mortality (4,133 deaths from 15 cohorts), coronary heart disease (CHD) (5,420 events from 9 cohorts), stroke (2,651 events from 9 cohorts), or heart failure (2,507 events from 8 cohorts). To compare eGFR and ACR with conventional predictors independently of the order of modeling, we examined the worsening of 5-year prediction of CVD outcomes by omitting each predictor in turn compared to a full model with all kidney and conventional predictors. Results: C-statistics for full models ranged from 0.759-0.836 in general population and high risk cohorts and 0.712-0.796 in the CKD population (Table). All the conventional and kidney measures contributed to better prediction of CVD outcomes. The contribution of ACR was greater than that of any conventional modifiable risk factors except in predicting CHD in both general/high-risk cohorts and CKD population. Although weaker than ACR, eGFR also contributed significantly to better prediction of CVD mortality (especially in CKD populations) and CHD. Largely similar results were observed for categorical net reclassification index. Conclusion: The two key kidney measures (particularly albuminuria) contribute as much as some or all of the conventional risk factors to CVD prediction, supporting their use for CVD risk classification in certain circumstances.

Prognostic Factors for Developing Thrombosis in Polycytemia Vera: A Retrospective Analysis of 331 Patients with Long-Term Follow-up Highlights the Importance of White Blood Cells Levels

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 48-49
Author(s):  
Samantha Ferrari ◽  
Chiara Pagani ◽  
Mariella D'Adda ◽  
Nicola Bianchetti ◽  
Annamaria Pelizzari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
High Risk ◽  
Board Of Directors ◽  
Advisory Board ◽  
Advisory Committees ◽  
Risk Status ◽  
History Of ◽  
Wbc Count

Polycythemia Vera (PV) is a chronic myeloproliferative neoplasm characterized by erythrocytosis, constitutively active mutations in JAK2 and an increased susceptibility to thrombotic events (TEs). There is still controversy about the role of increased hematocrit and of other variables including elevated white blood cell count as risk factors for the occurrence of TEs. A better definition of the relative prognostic importance of hematologic parameters would help us to better tailor the therapeutic approach to PV patients (pts), which is currently mainly based on the use of acetilsalycilic acid (ASA), venesection and hydroxyurea . The aim of our study was to analyze if any clinical or laboratory variables were significantly associated to the occurrence of TEs both at PV diagnosis and during the course of the disease in a large series of PV pts uniformly followed at a single Center over a period of 29.5 years from January 1986 to June 2019. Clinical and laboratory data were obtained from the time of diagnosis until death, progression to acute leukemia or last follow-up. Hematocrit (Hct), hemoglobin (Hb), white blood cell (WBC) and platelet (PLT) levels were recorded for each patient at least every 6 months. Among a total of 331 pts, the median age was 65 years (range 30-92 years), and 56% were male. "High risk" features (age ≥ 60 years and/or history of prior thrombosis) were present in 221 pts (66.7%). The incidence of cardiovascular risk factors was: hypertension 64%, diabetes 15%, hyperlipidemia 28%, history of active or remote smoking 41%. Patients on ASA were 279 (84%), 19 (6%) were on oral anticoagulation, while 27 (8%) were on ASA+oral anticoagulant. At PV diagnosis 54 pts (16%) presented with thrombosis, arterial in 32 (59%) and venous in 22 (41%). A previous TE was recorded in 57 pts (17%): in 43 (75%) arterial, in 12 (22%) venous and in 2 (3%) mixed (arterial+venous). Previous thrombosis was the only variable significantly associated with the presence of a TE at PV diagnosis (P=0.02). After PV diagnosis, with a median follow-up of 81 months (range 1-374 months), 63 pts (19%) experienced a TE and 11 of them a further episode, for a total of 74 TEs. The incidence rate (pts/year) of TEs was 2.7%. Forty-two events were arterial (57%), 31 were venous (42%) and 1 (1%) was mixed. It was the first TE for 37 pts. Cerebrovascular accidents and deep-venous thrombosis were the most frequent arterial and venous TEs both at PV diagnosis and throughout the disease course, with a relative incidence of 50% and 32% respectively. The table compares the characteristics of patients who did or did not develop a TE after PV diagnosis. At univariate analysis, PV high risk status, a previous TE and hyperlipidemia at PV diagnosis were significantly associated with a subsequent TE. Among hematologic variables an elevated WBC count at the time of thrombosis, but not Hct or PLT levels, was highly significantly associated with the development of a TE. At multivariate analysis, WBC count ≥10.4 x 10^9/L and hyperlipidemia maintained their independent prognostic value, while high risk status and a previous TE lost their prognostic significance. Both at univariate and multivariate analysis, hyperlipidemia at diagnosis (P=0.009 and P=0.002) and high WBC count at thrombosis (P=0.001 and P=<0.0001) predicted for arterial thromboses, while only a history of prior thrombosis (P=0.03) predicted for venous ones. In conclusion, our analysis confirms that elevated WBC count at the moment of the event more than increased hematocrit is associated to the development of thrombosis in PV pts. We also found that hyperlipidemia was an independent risk factor for arterial thrombosis, calling for an accurate management of increased lipid levels. Whether a reduction of the WBC count during the course of PV may reduce the frequency of TE remains to be demonstrated by prospective studies. Table Disclosures D'Adda: Novartis: Other: Advisory board; Incyte: Other: Advisory board; Pfizer: Other: Advisory board. Rossi:Daiichi Sankyo: Consultancy, Honoraria; Sanofi: Honoraria; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees; Novartis: Other: Advisory board; Alexion: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria; Celgene: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Jazz: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees.

scholarly journals Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Bone Marrow ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cell Activity ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

scholarly journals Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study

2011 ◽  
Vol 70 (6) ◽  
pp. 1083-1086 ◽  
Author(s):  
Amelia Ruffatti ◽  
Teresa Del Ross ◽  
Manuela Ciprian ◽  
Maria T Bertero ◽  
Sciascia Salvatore ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Univariate Analysis ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Ischaemic Attack ◽  
Independent Risk Factors

ObjectivesTo assess risk factors for a first thrombotic event in confirmed antiphospholipid (aPL) antibody carriers and to evaluate the efficacy of prophylactic treatments.MethodsInclusion criteria were age 18–65 years, no history of thrombosis and two consecutive positive aPL results. Demographic, laboratory and clinical parameters were collected at enrolment, once a year during the follow-up and at the time of the thrombotic event, whenever that occurred.Results258 subjects were prospectively observed between October 2004 and October 2008. The mean±SD follow-up was 35.0±11.9 months (range 1–48). A first thrombotic event (9 venous, 4 arterial and 1 transient ischaemic attack) occurred in 14 subjects (5.4%, annual incidence rate 1.86%). Hypertension and lupus anticoagulant (LA) were significantly predictive of thrombosis (both at p<0.05) and thromboprophylaxis was significantly protective during high-risk periods (p<0.05) according to univariate analysis. Hypertension and LA were identified by multivariate logistic regression analysis as independent risk factors for thrombosis (HR 3.8, 95% CI 1.3 to 11.1, p<0.05, and HR 3.9, 95% CI 1.1 to 14, p<0.05, respectively).ConclusionsHypertension and LA are independent risk factors for thrombosis in aPL carriers. Thromboprophylaxis in these subjects should probably be limited to high-risk situations.

scholarly journals Recurrent Atherosclerotic Cardiovascular Event Rates Differ Among Patients Meeting the Very High Risk Definition According to Age, Sex, Race/Ethnicity, and Socioeconomic Status

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Jaejin An ◽  
Yiyi Zhang ◽  
Paul Muntner ◽  
Andrew E. Moran ◽  
Jin‐Wen Hsu ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
High Risk ◽  
Sociodemographic Factors ◽  
Study Cohort ◽  
Atherosclerotic Cardiovascular Disease ◽  
Annual Household Income ◽  
History Of ◽  
Race Ethnicity ◽  
Definition Of ◽  
Very High

Background The risk for atherosclerotic cardiovascular disease (ASCVD) events may differ by sociodemographic factors among patients meeting the definition of very high risk according to the 2018 American Heart Association/American College of Cardiology cholesterol guideline, leading to treatment disparities. We estimated the risk for recurrent ASCVD events among adults meeting the definition of very high risk by age, sex, race/ethnicity, and socioeconomic status in a US integrated healthcare system. Methods and Results The study cohort included Kaiser Permanente Southern California members aged ≥21 years with a history of clinical ASCVD on September 30, 2009. Very high risk for recurrent ASCVD was defined by a history of ≥2 major ASCVD events or a history of 1 major event along with ≥2 high‐risk conditions. Patients were followed through 2015 for a first recurrent ASCVD event. Of 77 101 patients with ASCVD, 50.8% met the definition for very high risk. Among patients meeting the definition of very high risk, recurrent ASCVD rates were higher in older (>75 years) versus younger patients (21–40 years) (sex‐adjusted hazard ratio [HR] [95% CI] 1.85; 1.23–2.79), non‐Hispanic Black patients versus non‐Hispanic White patients (age‐, sex‐adjusted HR, 1.32; 1.23–1.41), those who lived in neighborhoods with lower (<$35k) versus higher annual household income (≥$80k) (HR, 1.20; 1.11–1.30), or with lower (≥31.2%) versus higher education levels (<8.8% high school or lower) (HR, 1.26; 1.19–1.34). Conclusions Disparities in the risk for recurrent ASCVD events were present across sociodemographic factors among very high risk patients. The addition of sociodemographic factors to current definitions of very high risk could reduce health disparities.

Identification Of Patients (pts) With Chronic Myeloid Leukemia (CML) At High Risk Of Artery Occlusive Events (AOE) During Treatment With The 2nd Generation Tyrosine Kinase Inhibitor (TKI) Nilotinib, Using Risk Stratification For Cardiovascular Diseases (CVD)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2726-2726 ◽  
Author(s):  
Delphine Rea ◽  
Tristan Mirault ◽  
Emmanuel Raffoux ◽  
Jean-Michel Miclea ◽  
Philippe Rousselot ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Median Time ◽  
Median Duration ◽  
Cumulative Incidence ◽  
Risk Estimation ◽  
Cvd Risk ◽  
Significant Difference ◽  
History Of ◽  
Very High

Background Nilotinib is approved for use in pts with CML after failure of imatinib and in newly diagnosed CP-CML. However, several studies report a nilotinib-associated risk of AOE, especially in pts with preexisting risk factors for CVD. Since CVD are a major cause of disability and death worldwide and result from complex interactions between multiple risk factors, we aimed at determining whether CVD risk estimation using the 2012 European Society of Cardiology (ESC) classification could be useful to identify patients at high risk of AOE during nilotinib therapy. Methods Pts (n=75) treated with nilotinib upfront or after failure of prior TKI at our institution were included provided that baseline risk factors for CVD and prior history of established CVD could be retrospectively collected. Risk factors included age, tobacco use, diabetes mellitus (DM), arterial hypertension (AH), dyslipidemia and increased body mass index (BMI). Patients were categorized into 2 groups according to ESC 2012 classification: low/moderate (L/M) and high/very high (H/VH) CVD risk. H/VH included pts with any of the following: established CVD, DM, severe AH, familial dysplipidemia or a SCORE (systematic coronary risk evaluation project) ≥5%. Results At nilotinib initiation, median age was 51 years (19-76), 41 pts (54.7%) were males. Nilotinib was given upfront in 28 pts (37%) and after failure of imatinib or dasatinib following imatinib in 47 pts (63%). Median time from diagnosis was 1 month (0.3-4) in the former group and 25 months (2-130) in the latter. Median duration of TKI exposure prior to nilotinib in the latter group was 22 months (0.4-91). Initial nilotinib dosing regimen was 400mg BID in 42 pts (56%) and 300mg BID in 33 pts (44%). Median duration of nilotinib treatment of 28 months (3-76) and median follow-up was 30 months (3-77). At baseline, medical history revealed H/VH risk category in 15 pts (20%) including established CVD in 6 pts (8%) (all diagnosed before CML), DM in 10 pts (13.3%), severe AH in 1 pt (1.3%), familial dyslipidemia in 1 pt (1.3%) and a SCORE ≥5% in 2 pts (2.6%). Median number of CVD risk factors was 1 (0-6) including age ≥ 45 years in men and ≥ 55 years in women in 37 pts (49.3%), active smoking or ceased during the previous year in 12 pts (16.7%), DM in 10 pts (13.3%), AH in 14 pts (18.7%), dyslipidemia in 10 pts (13.3%) and BMI ≥ 25 kg/m2in 20 pts (38.6). Nilotinib was discontinued in 23 pts (30.7%) due to adverse events (10 pts), resistance (7 pts), TKI discontinuation study (4 pts) or death (2 pts). AOE occurred in 12 pts after a median duration of nilotinib treatment of 24 months (9-47). AOE included myocardial infarction (MI) or coronary heart disease (CHD) (n=3), cerebrovascular events (CeVD) (n=3) and peripheral artery disease (PAD) (n=6). Overall, the cumulative incidence of AOE was 2.91% (95% CI: 0.74-11.42) by 12 months, 9.81% (95% CI: 4.57-21.08) by 24 months, 19.29 (95% CI: 10.77-34.56) by 36 months and 27.7% (95% CI: 16.2-47.35) by 48 months (discontinuation of nilotinib and death as competing risks). Cumulative incidence of AOE by 48 months was 72.22% (95% CI: 47.46-100) in the H/VH group and only 12.13% (95% CI: 4.32-34.08) in the L/M group. Log Rank comparison of Kaplan Meier analysis of 48-month survival without AOE showed a significant difference between the 2 groups (27.78% (95% CI: 0-58.9) versus 84.38% (95% CI: 67.04-100) p=0.0001). Sensitivity of the ESC classification in nilotinib-treated patients was 67% and specificity 89%. It is important to note that all pts with a history of AOE had recurrent AOE on nilotinib. Nilotinib was discontinued in 11 pts with AOE after a median time of 288 days (1-688), 7 pts had recurrent or worsening AOE before nilotinib discontinuation and 2 pts died from AOE. Conclusions In our retrospective study, CVD risk estimation according to the 2012 ESC classification reveals that pts who belong to the H/VH risk group at baseline are at very high risk of AOE during nilotinib therapy. These findings now need to be validated in a prospective fashion. Nevertheless, we readily recommend that assessment of CVD risk should be performed in all pts considered for nilotinib therapy. Alternative TKI may be chosen whenever possible in pts at H/VH risk of CVD. In those treated with nilotinib, CVD risk should be reassessed throughout therapy and risk factors should be tightly controlled according to current guidelines. Disclosures: Rea: BMS: Honoraria; Novartis: Honoraria; Pfizer: Honoraria; ARIAD: Honoraria; Teva: Honoraria. Messas:Novartis: Honoraria.

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