Thrombotic episodes in myeloproliferative neoplasms: A population based study.

Abstract

e18554 Background: Myeloproliferative neoplasms (MPN) are complicated with high incidence of thrombotic episodes, often requiring chronic anticoagulation in high risk patients (pts). To improve our knowledge on risk stratification, we undertook a large population study on National Inpatient Sample (NIS) to investigate the demographic and health factors associated with venous thromboembolism (VTE) and acute coronary syndrome (ACS) in pts with MPN. Methods: In this retrospective cohort study using the most recent 2016 NIS, we included all pts with discharge diagnosis (dx) of MPN with or without current or prior dx of VTE and ACS using appropriate ICD-10 codes. Demographic and health characteristics were compared between groups. Multivariate logistic regression was done to compare length of stay and cost of care. STATA 13.0 was used for statistical analysis. Results: Among 162,435 pts with MPN, 3750 (2.3%) had VTE and 2820 (1.73%) had ACS. MPN pts with VTE had significantly higher age (mean 61.3 years) compared to those without VTE (mean 59.3 years). Smoking, obesity, and JAK2 mutation were significantly more common in MPN with VTE group. Pts with MPN and ACS were significantly older than those without ACS (67.85 vs. 59.2 years). These pts were mostly males and more likely to have hypertension, diabetes, smoking, dyslipidemia, obesity, and chronic kidney disease as comorbidities. Total hospital cost was significantly higher in MPN pts with VTE and ACS. Conclusions: In agreement with prior reports, age, smoking, and presence of JAK-2 mutation seem to be an important prognostic factors for both VTE and ACS in MPN. Other common comorbidities mandate critical consideration in assessment of thrombotic risk in MPN pts. [Table: see text]