酪氨酸激酶抑制剂与慢性髓性白血病患者血脂谱相关的心血管事件风险

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
María Nieves Sáez Perdomo, R. Stuckey, Elena González-Pérez, Santiago Sánchez-Sosa, Paula Estupiñan-Cabrera, Sunil Lakhwani Lakhwani, J. D. González San Miguel, Nuria Hernanz Soler, Marina Gordillo, Gloria González Brito, María Tapia-Torres, Ana Ruano, Adrián Segura-Díaz, H. Luzardo, C. Bilbao-Sieyro, M. Gómez-Casares
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引用次数: 0

摘要

背景:目前,第二代和第三代酪氨酸激酶抑制剂(TKIs)可用于治疗慢性期慢性髓性白血病(CP-CML)的一线和二线治疗。然而,有报道称使用某些TKIs治疗的CML患者会出现血管不良事件(VAEs)。方法:我们回顾性评估了210名CML患者的累积发病率(CI)和心血管风险。结果在平均 6 年的随访中,19/210(9.1%)名患者出现了 VAE,所有这些患者在诊断时都至少存在一个心血管风险因素。从开始接受 TKI 治疗到出现 VAE 的平均时间为 54 个月。我们发现,尼罗替尼治疗无效的患者与尼罗替尼治疗无效的患者(P = 0.005)、达沙替尼治疗无效的患者与达沙替尼治疗无效的患者(P = 0.039)以及接受一线伊马替尼三线治疗的患者与接受一线伊马替尼三线治疗的患者(P < 0.001)的CI之间存在显著统计学差异。在多变量逻辑回归分析中,弗拉明汉风险评分(FRS)和接受一线伊马替尼三线 TKI 治疗的患者是唯一对 VAE 发生具有显著统计学危险比的变量。高密度脂蛋白胆固醇(HDL-C)和总胆固醇的显著增加也可预测VAE的发生。结论总之,在诊断 CML 时估计心血管风险非常重要,因为这有助于确定患者在 TKI 治疗期间是否可能发生 VAE。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Cardiovascular Event Risk Associated with Tyrosine Kinase Inhibitors and the Lipid Profile in Patients with Chronic Myeloid Leukemia
Background: Second- and third-generation tyrosine kinase inhibitors (TKIs) are now available to treat chronic-phase chronic myeloid leukemia (CP-CML) in the first and second line. However, vascular adverse events (VAEs) have been reported for patients with CML treated with some TKIs. Methods: We retrospectively evaluated the cumulative incidence (CI) and cardiovascular risk for 210 patients included in the Canarian Registry of CML. Result: With a mean follow up of 6 years, 19/210 (9.1%) patients developed VAEs, all of whom presented at least one cardiovascular risk factor at diagnosis. The mean time to VAE presentation was 54 months from the start of TKI treatment. We found a statistically significant difference between the CI for nilotinib-naïve vs. nilotinib-treated patients (p = 0.005), between dasatinib-naïve and dasatinib-treated patients (p = 0.039), and for patients who received three lines of treatment with first-line imatinib vs. first-line imatinib (p < 0.001). From the multivariable logistic regression analyses, the Framingham risk score (FRS) and patients with three lines of TKI with first-line imatinib were the only variables with statistically significant hazard ratios for VAE development. Significant increases in HDL-C and total cholesterol may also be predictive for VAE. Conclusions: In conclusion, it is important to estimate the cardiovascular risk at the diagnosis of CML as it can help determine whether a patient is likely to develop a VAE during TKI treatment.
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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