Predictors of cardiovascular events and all‐cause of death in patients with transfusion‐dependent myelodysplastic syndrome

• DOI: 10.1111/bjh.17652
• Publication Date: 2021-06-28T09:52:55Z
• Authors: Marta Alonso‐Fern...; Ana Martin‐Garcia; Agustin C. Martin...; Felix Lopez‐Cadenas; Elena Diaz‐Pelaez; Tamara Jimenez‐Solas; Teresa Gonzalez‐M...; Clara Sanchez‐Pablo; Maria Diez‐Campelo; Pedro L. Sanchez
• Keywords: Male; Risk; Iron Overload; Kaplan-Meier Estimate; 03 medical and health sciences; 0302 clinical medicine; Cause of Death; Humans; Blood Transfusion; Prospective Studies; Aged; Aged, 80 and over; T1 mapping; Middle Aged; Cardiovascular disease; Prognosis; Magnetic Resonance Imaging; 3. Good health; Feature tracking; NT-proBNP; Cardiovascular Diseases; Myelodysplastic Syndromes; Female; Myelodysplastic syndrome; Biomarkers; Follow-Up Studies

Summary Cardiovascular disease (CVD) involves the second cause of death in low‐risk myelodysplastic syndrome (MDS) population. Prospective study to characterise CVD and identify predictors for combined event (CE) cardiovascular and/or all‐cause mortality transfusion dependent MDS patients. Thirty‐one patients underwent a cardiac assessment including biomarkers magnetic resonance (cMR) with parametric sequences (T1, T2 T2* mapping) myocardial deformation by feature tracking (FT) were analysed clonal hematopoiesis indeterminate potential mutations. Cardiac revealed high prevalence unknown structural heart (51% cMR pathological findings). After 2·2 [0·44] years follow‐up, 35·5% suffered CE: 16% death, 29% event. At multivariate analysis elevated NT‐proBNP ≥ 486pg/ml (HR 96·7; 95%‐CI 1·135–8243; P = 0·044), reduced native T1 time < 983ms 44·8; 1·235–1623; 0·038) higher left ventricular global longitudinal strain (LV‐GLS) 0·4; 0·196–0·973; 0·043) showed an independent prognostic value. These variables, together 20ms, additive value (Log Rank: 12·4; 0·001). In conclusion, frequently suffer CVD. value, relaxation FT are poor prognosis, thus, their determination would high‐risk who could benefit from treatment follow‐up.