Mortality and major cardiovascular events among patients with multiple myeloma: Analysis from a nationwide French medical information database

Abstract

Based on a nationwide hospitalization database, we aimed to assess the risk of all-cause death and CV outcomes in MM patients. From 1st January to 31st December 2013, 3,381,472 adults were hospitalized for any reason in French hospitals. We identified 15,774 patients diagnosed with known MM at baseline. The outcome analysis (all-cause death, cardiovascular [CV] death, myocardial infarction (MI), ischemic stroke or hospitalization for major bleeding) was performed with follow-up starting at the time of last event. For each patient with MM, a propensity score-matched patient without MM was selected. The mean follow-up in the propensity score-matched population was 3.7 ± 2.3 years. Matched patients with MM had a higher risk of all-death (yearly rate 20.02 vs. 11.39%/year) than patients without MM. No difference was observed between MM group and no myeloma group for CV death (2.00 vs. 2.02%/year). The rate of MI and stroke was lower in the MM group, respectively for incidence rate, 0.86 vs. 0.97%/year and 0.85 vs. 1.10%/year. In contrast, MM group had a higher rate of rehospitalization for major bleeding, with an incidence rate of 3.61 vs. 2.24%/year, and a higher risk of intracranial bleeding (1.03 vs. 0.84%/year). From a large nationwide database, we show that while patients with MM did not have a higher risk of CV death, their risk of mortality was higher due to major bleeding and intracranial bleeding. Our findings highlight the key issue of anticoagulation treatment management in patients with MM.