Trends and disparities in cardiovascular disease-related mortality among adults with myeloproliferative neoplasms in USA.

European heart journal open Pub Date : 2024-12-18 eCollection Date: 2025-01-01 DOI:10.1093/ehjopen/oeae101
Siddharth Agarwal, Usama Qamar, Muhammad Shahzeb Khan, Taha Al-Juhaishi, Abdul Rafeh Naqash, Avirup Guha, Eric H Yang, Ana Barac, Zain Ul Abideen Asad
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Abstract

Aims: We aimed to perform a retrospective cohort study using the Centers for Disease Control and Prevention's (CDC's) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database to analyse the trends in cardiovascular disease (CVD)-related mortality in patients with myeloproliferative neoplasms (MPNs) from 1999 to 2020.

Methods and results: We analysed the death certificate data from the CDC WONDER database from 1999 to 2020 for CVD with co-morbid myeloproliferative disorders in the US population. Age-adjusted mortality rates (AAMRs) and 95% confidence intervals (CIs) were computed per 1 million population by standardizing crude mortality rates to the 2000 US census population. To assess annual national mortality trends, we employed the Joinpoint regression model, calculating the annual per cent change in AAMR and corresponding 95% CIs. A total of 15 269 deaths related to CVD occurred in patients with co-morbid MPNs from 1999 to 2020. Overall, there was a decreasing trend in CVD-related AAMRs throughout these years. Males contributed to 51% of total deaths, and their AAMR was persistently higher than women throughout the study. Non-Hispanic (NH) Whites had the highest overall AAMR, followed by NH Blacks, NH American Indians or Alaska Natives, Hispanics or Latinos, and NH Asian or Pacific Islanders.

Conclusion: Our findings indicate a significant decline with notable gender, racial/ethnic, and regional differences in CVD-related mortality among patients with MPN over the past two decades. We emphasize the importance of a collaborative approach between oncologists and cardiologists in managing these patients, highlighting the potential benefits of integrating cardio-oncology services to enhance patient outcomes.

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美国成人骨髓增生性肿瘤患者心血管疾病相关死亡率的趋势和差异
目的:我们旨在使用疾病控制和预防中心(CDC)广泛的流行病学研究在线数据(WONDER)数据库进行回顾性队列研究,分析1999年至2020年骨髓增生性肿瘤(mpn)患者心血管疾病(CVD)相关死亡率的趋势。方法和结果:我们分析了1999年至2020年CDC WONDER数据库中美国人群CVD合并骨髓增生性疾病的死亡证明数据。通过标准化2000年美国人口普查人口的粗死亡率,计算每100万人的年龄调整死亡率(AAMRs)和95%置信区间(ci)。为了评估年度全国死亡率趋势,我们采用了Joinpoint回归模型,计算AAMR的年度变化百分比和相应的95% ci。从1999年到2020年,共有15269例与心血管疾病相关的死亡发生在合并mpn的患者中。总体而言,近年来心血管疾病相关的AAMRs呈下降趋势。男性占总死亡人数的51%,在整个研究过程中,他们的AAMR一直高于女性。非西班牙裔(NH)白人的总体AAMR最高,其次是NH黑人、NH美洲印第安人或阿拉斯加原住民、西班牙裔或拉丁裔、NH亚洲人或太平洋岛民。结论:我们的研究结果表明,在过去的20年里,MPN患者的心血管疾病相关死亡率显著下降,且存在显著的性别、种族/民族和地区差异。我们强调肿瘤学家和心脏病专家在管理这些患者时合作方法的重要性,强调整合心脏肿瘤学服务以提高患者预后的潜在益处。
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