Clinical characteristics and in-hospital mortality of chronic myeloid leukemia patients with ischemic heart disease: insights from the JROAD-DPC registry.

European heart journal open Pub Date : 2025-08-18 eCollection Date: 2025-09-01 DOI:10.1093/ehjopen/oeaf101
Akito Shindo, Hiroshi Akazawa, Tomomi Ueda, Hiroshi Kadowaki, Junichi Ishida, Issei Komuro
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Abstract

Aims: Chronic myeloid leukemia (CML) patients are at high risk for developing cardiovascular (CV) diseases due to adverse effects of BCR-ABL tyrosine kinase inhibitors.

Objectives: The purpose of this study was to compare patient characteristics and in-hospital mortality between CML patients and non-CML patients, who were hospitalized for ischemic heart disease (IHD).

Methods and results: This study was based on the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination (JROAD-DPC) database. All patients who were first hospitalized for IHD and received percutaneous coronary intervention from April 2012 to March 2021 were extracted. Propensity score matching was used to reduce confounding effects related to differences in patient background. A total of 766 385 patients, in which 371 CML patients were included, were analyzed. CML patients were more likely to be male and less likely to have obesity, hypertension, and dyslipidemia. The number of modifiable CV risk factors (obesity, smoking, hypertension, dyslipidemia, and diabetes mellitus) in CML patients was smaller than in non-CML patients. There was no difference in in-hospital mortality, whether considering all cases or only acute myocardial infarction cases. This was also statistically non-significant after propensity score matching.

Conclusion: CML patients were hospitalized for IHD with fewer CV risk factors than non-CML patients, and in-hospital mortality was comparable between CML and non-CML patients. These findings emphasize the need for more stringent management of modifiable CV risk factors for CML patients.

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慢性髓性白血病合并缺血性心脏病患者的临床特征和住院死亡率:来自JROAD-DPC登记的见解
目的:由于BCR-ABL酪氨酸激酶抑制剂的不良反应,慢性髓性白血病(CML)患者发生心血管(CV)疾病的风险很高。目的:本研究的目的是比较因缺血性心脏病(IHD)住院的CML患者和非CML患者的患者特征和住院死亡率。方法和结果:本研究基于日本所有心血管疾病登记和诊断程序组合(JROAD-DPC)数据库。2012年4月至2021年3月期间首次因IHD住院并接受经皮冠状动脉介入治疗的所有患者均被取出。倾向评分匹配用于减少与患者背景差异相关的混淆效应。共分析766385例患者,其中包括371例CML患者。慢性粒细胞白血病患者多为男性,较少出现肥胖、高血压和血脂异常。CML患者可改变的CV危险因素(肥胖、吸烟、高血压、血脂异常和糖尿病)的数量少于非CML患者。无论是考虑所有病例还是仅考虑急性心肌梗死病例,住院死亡率均无差异。在倾向评分匹配后,这在统计学上也不显著。结论:CML患者因IHD住院时CV危险因素低于非CML患者,住院死亡率在CML和非CML患者之间具有可比性。这些发现强调需要对CML患者的可变CV危险因素进行更严格的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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