Value of P-selectin in the prognosis of cardiovascular events in patients with multiple myeloma

Abstract

Multiple myeloma (MM) survival has greatly improved in recent decades. MM is usually diagnosed in elderlies. Patients do not necessarily die from MM, so cardiovascular health may be a key factor threatening long-term survival. The aim of the research: to evaluate the prognostic value of circulating P-selectin for cardiovascular events in patients with multiple myeloma in full or partial remission. Materials and methods. 97 patients with MM with complete or partial remission were enrolled in the study. None of the patients had received any lipid-modulating medications, including statins or fibrates, before enrollment. The observation period was up to 1 year. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of P-selectin was used. Results. During the observation period progression of MM was proved in 25 patients, 5 persons were excluded for poor follow-up. 67 patients were included in the statistical analysis. Thirty-six cumulative clinical events occurred in 18 patients (26.9 %) within the follow-up, with their distribution being as follows: 2 cardiovascular deaths, 16 cardiac arrhythmias, 3 cardiac ischemic events, 1 stroke, 4 chronic heart failures, and 10 hospital admissions for cardiovascular reasons. 2 deaths were not related with cardiovascular pathology. Medians of circulating levels of P-selectin in free-events subject cohort and subjects cohort with cardiovascular events were 58.24 ng/ml (95 % confidence interval (CI) = 32.27–77.48 ng/ml) and 87.57 ng/ml (95 % CI = 51.12–114.89 ng/ml) (Р < 0.01). In multivariate logistic regression circulating P-selectin independently predicted cumulative cardiovascular events (odds ratio (OR) = 1.11; 95 % CI = 1.08–1.15; Р = 0.02) in patients after sever coronavirus disease (COVID-19) within 1 year of observation period. Conclusions. Among patients with documented multiple myeloma in remission increased circulating P-selectin was associated with increased cumulative cardiovascular events.