The new Systematic Coronary Risk Evaluation (SCORE2 and SCORE2-OP) estimates the risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib or ponatinib

被引：5

作者：

Mulas, Olga ^{[1
]}

Abruzzese, Elisabetta ^{[2
]}

Luciano, Luigiana ^{[3
]}

Iurlo, Alessandra ^{[4
]}

Attolico, Immacolata ^{[5
]}

Castagnetti, Fausto ^{[6
]}

Galimberti, Sara ^{[7
]}

Bonifacio, Massimiliano ^{[8
]}

Annunziata, Mario ^{[9
]}

Gozzini, Antonella ^{[10
]}

Orlandi, Ester Maria ^{[11
]}

Stagno, Fabio ^{[12
]}

Binotto, Gianni ^{[13
]}

Pregno, Patrizia ^{[14
]}

Fozza, Claudio ^{[15
]}

Loi, Maurizio ^{[1
]}

Trawinska, Malgorzata Monika ^{[2
]}

De Gregorio, Fiorenza ^{[3
]}

Cattaneo, Daniele ^{[4
]}

Albano, Francesco ^{[16
]}

Iezza, Miriam ^{[6
]}

Barate, Claudia ^{[7
]}

Scaffidi, Luigi ^{[8
]}

Elena, Chiara ^{[11
]}

Giai, Valentina ^{[14
]}

Scalzulli, Emilia ^{[17
]}

Breccia, Massimo ^{[17
]}

La Nasa, Giorgio ^{[1
]}

Caocci, Giovanni ^{[1
,18
]}

机构：

[1] Univ Cagliari, Businco Hosp, Dept Med Sci & Publ Hlth, Hematol Unit, Cagliari, Italy

[2] Tor Vergata Univ, Sant Eugenio Hosp, Hematol Unit, Rome, Italy

[3] Univ Naples Federico II, Hematol Unit Federico II, Naples, Italy

[4] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Hematol Unit, Milan, Italy

[5] Azienda Osped Univ Consorziale AOUC Policlin, Hematol & Stem Cell Transplantat Unit, Bari, Italy

[6] Univ Bologna, S Orsola Malpighi Hosp, Dept Expt Diagnost & Specialty Med, Bologna, Italy

[7] Univ Pisa, Dept Clin & Expt Med, Sect Hematol, Pisa, Italy

[8] Univ Verona, Dept Med, Sect Hematol, Verona, Italy

[9] Cardarelli Hosp, Hematol Unit, Naples, Italy

[10] Univ Florence, Hematol Unit, AOU Careggi, Florence, Italy

[11] Fdn IRCCS Policlin S Matteo, Div Hematol, Pavia, Italy

[12] Rodolico Hosp, Hematol Unit, AOU Policlin V Emanuele, Catania, Italy

[13] Univ Padua, Hematol Unit, Padua, Italy

[14] Azienda Osped Univ Citta Salute & Della Sci, Hematol Unit, Turin, Italy

[15] Univ Sassari, Dept Med Surg & Expt Sci, Sassari, Italy

[16] Univ Bari Aldo Moro, Dept Precis & Regenerat Med & Ionian Area DiMePRe, Hematol & Stem Cell Transplantat Unit, Bari, Italy

[17] Sapienza Univ, Dept Cellular Biotechnol & Hematol, Hematol, Rome, Italy

[18] Univ Cagliari, Osped Businco, Dipartimento Sci Med & Sanita Pubbl, SC Ematol & CTMO, Via Jenner, Sn, I-09124 Cagliari, Italy

来源：

ANNALS OF HEMATOLOGY | 2024年 / 103卷 / 02期

关键词：

Chronic myeloid leukemia; Ponatinib; Nilotinib; Arterial occlusive event; Prophylaxis; SCORE2; TYROSINE KINASE INHIBITORS; CARDIOVASCULAR EVENTS; MOLECULAR RESPONSE; ADVERSE EVENTS; POPULATION; PREVENTION; DISEASES; THERAPY;

D O I：

10.1007/s00277-023-05556-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Patients with chronic myeloid leukemia (CML) treated with nilotinib or ponatinib may experience arterial occlusive events (AOEs). It is currently recommended to thoroughly assess cardiovascular risk factors before treating CML. We identified 455 consecutive CML adult patients, 335 treated with nilotinib and 120 with ponatinib; 380 patients without previous cardiovascular diseases or diabetes were stratified according to the Systematic Coronary Risk Evaluation (SCORE2) and SCORE2-Older Persons (SCORE2-OP). This updated algorithm from the European Society of Cardiology (ESC) estimates a 10-year risk of fatal and non-fatal cardiovascular diseases. It is based on sex, age, smoking habits, systolic blood pressure, non-high-density lipoprotein cholesterol, and European geographical region of cardiovascular risk. The SCORE2/SCORE2-OP algorithm translated more patients (50.2%) to the high-very high cardiovascular risk category than the previous SCORE (25.3%). Patients with a high to very high SCORE2/SCORE2-OP risk showed a significantly higher incidence rate of AOEs (69.2% vs. 46.5%, p < 0.001). The older SCORE was less specific in estimating AOEs in patients classified as low-intermediate risk (69.8 vs. 54.2%). In multivariate analysis, no associations were found between AOEs and gender, age, and type or dose of tyrosine kinase inhibitor. Only the SCORE2/SCORE2-OP risk was confirmed as a significant predictive factor (p = 0.028; hazard ratio = 2.2; 95% confidence interval = 1.1-4.5). Patients with AOEs required, in most cases, imaging diagnostic tests, additional drugs, and sometimes invasive procedures, increasing access to visits and hospital management. This real-life study suggested that the SCORE2 and SCORE2-OP charts could help identify cardiovascular fragility in CML patients providing them with more attention and a proper TKI selection.

引用

页码：427 / 436

页数：10

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