Abstract 12744: Outcomes of Patients With Myeloproliferative Neoplasms Admitted for Myocardial Infarction: Insights From National Inpatient Sample

Abstract

Introduction: Myeloproliferative neoplasms (MPNs) are chronic clonal stem cell neoplasms with high risk of thrombosis and cardiovascular events. However, outcomes after acute myocardial infarction (AMI) and risk factors for cardiovascular events after AMI in patients with MPN have not been well characterized. Methods: Adult patients with a primary admission of AMI from September 2015 to December 2018 (N = 699,786) with (N = 3,156) and without (N = 696,586) a diagnosis of MPN were identified using the National Inpatient Sample. Primary outcome was composite inpatient major adverse cardiac events (MACE) of arterial and venous thrombosis, non-fatal cardiac arrest, and mortality. Patients with and without MPN were compared using propensity score estimation using Generalized Boosted Models(GBM). Outcomes between groups were compared using multivariable logistic regression. Results: Patient characteristics are described in Table 1. Patients with MPN were more likely to have a history of heart failure and less likely to have a history of coronary artery disease compared with patients without MPN. Patients with MPN were less likely to undergo revascularization despite similar rates of STEMI. After propensity score weighting with GBM and multivariable logistic regression, MPN patients had increased risk of MACE, arterial thrombosis, VTE and bleeding (Figure). Conclusions: Among patients hospitalized with AMI, those with MPN are at increased risk of MACE compared with patients without MPN. Revascularization is less utilized in patients with MPN. More investigation is needed in order to improve post-AMI outcomes in patients with MPN.