Cardiovascular risk factor in MPN patients
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LETTER TO THE EDITOR
Cardiovascular risk factor in MPN patients Vincenzo Accurso1 · Marco Santoro2 · Salvatirce Mancuso1 · Sergio Siragusa1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
To the Editor, Fernanda Salles Seguro et al. recently published an article entitled "Risk factors and incidence of thrombosis in a Brazilian cohort of patients with Philadelphia-negative myeloproliferative neoplasms" [1], describing, with a retrospective analysis, the thrombotic and hemorrhagic events that occurred in a cohort of 334 Brazilian patients with Phnegative chronic myeloproliferative diseases (MPNs) [2]. In this report the authors claim that the revised International Prognostic Score in ET for thrombosis (r-IPSETt) “stratifies patients in up to four risk categories using four variables: CV risk factors, age > 60 years, thrombosis history and JAK2 V617F”. Actually, this classification does not take into account the cardiovascular risk factors (CVR) which were instead assessed in the previous IPSET-t score [3]. CVR aren’t taken into account for polycythemia vera (PV) and myelofibrosis (MF). For patients with PV the thrombotic risk is currently assessed with the old traditional classification that distinguishes low-risk and high-risk patients, according to whether they are more or less than 60 years-old and to previous history of thrombosis. To date, there is no validated score for thrombotic risk in MF. However, there is evidence that one or more CVR such as cigarette smoking, hypertension, obesity, diabetes and dyslipidemia can increase thrombotic risk in MPN [4]. In a previously proposed thrombotic risk classification model, to the traditional high and low-risk category was added an intermediate-risk category, collecting all the patients aged under 60, with no history of thrombosis, but with the presence of CVR. This thrombotic risk classification model is almost not used in clinical practice [5].
* Vincenzo Accurso [email protected] 1
Hematology Divisione, University Hospital Policlinico “Paolo Giaccone”, Palermo, Italy
Dept of Surgical, Oncology and Stomatological Disciplines, University of Palermo, Palermo, Italy
2
Cerquozzi et al. explored the association of CVR with the occurrence of arterial or venous events at or following diagnosis; they found that older age (≥ 60 years), hypertension, diabetes, hyperlipidemia, and normal karyotype were associated with arterial events, whereas younger age (
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