In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database
Background: Myeloproliferative neoplasms (MPNs) are chronic leukemias associated with increased risk of cardiovascular (CV) events. Prior studies suggest patients with MPN are at increased risk of HF. Additionally, pre-clinical murine models harboring the JAK2 mutation, the most common driver mutati...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723001355 |
| _version_ | 1797398595148709888 |
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| author | Orly Leiva Jose Alvarez-Cardona Joan How Andrew Brunner Gabriela Hobbs |
| author_facet | Orly Leiva Jose Alvarez-Cardona Joan How Andrew Brunner Gabriela Hobbs |
| author_sort | Orly Leiva |
| collection | DOAJ |
| description | Background: Myeloproliferative neoplasms (MPNs) are chronic leukemias associated with increased risk of cardiovascular (CV) events. Prior studies suggest patients with MPN are at increased risk of HF. Additionally, pre-clinical murine models harboring the JAK2 mutation, the most common driver mutation in MPNs, have shown accelerated adverse cardiac remodeling in myocardial infarction and pressure overload HF models. However, clinical outcomes, including in-hospital and readmission outcomes, of patients with MPN admitted for HF have not been well characterized. Methods: Patients hospitalized for HF with and without MPN were identified using the 2017 and 2018 National Readmission Database. Propensity score matching (PSM) was performed to match 1 MPN with 10 non-MPN controls. Outcomes were in-hospital death, 90-day CV-related, HF-related, and all-cause readmissions. Logistic regression and Cox proportional hazards regression models were used to estimate risk of in-hospital death and 90-day readmission outcomes, respectively. Results: After PSM, 4,626 patients with MPN were matched with 46,260 without. Patients with MPN were associated with increased risk of in-hospital death (OR 1.17, 95% CI 1.00 – 1.35), 90-day CV-related (HR 1.10, 95% CI 1.02 – 1.18) and all-cause (HR 1.24, 95% CI 1.17 – 1.31) but not HF-related (HR 1.05, 95% CI 0.97 – 1.14) readmissions. Conclusion: Among patients hospitalized for HF, MPN was associated with increased risk of in-hospital death, and 90-day CV-related readmissions (driven primarily by thrombotic readmissions). Further investigation is needed in order to improve outcomes in patients with MPN and HF. |
| first_indexed | 2024-03-09T01:27:49Z |
| format | Article |
| id | doaj.art-dbb3fc9045b24469b179c3e022d8e4e1 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-03-09T01:27:49Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-dbb3fc9045b24469b179c3e022d8e4e12023-12-10T06:16:32ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-12-0149101304In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions DatabaseOrly Leiva0Jose Alvarez-Cardona1Joan How2Andrew Brunner3Gabriela Hobbs4Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United StatesDivision of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United StatesDivision of Hematology, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, United StatesDivision of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United StatesDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Corresponding author at: Division of Hematology Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, United States.Background: Myeloproliferative neoplasms (MPNs) are chronic leukemias associated with increased risk of cardiovascular (CV) events. Prior studies suggest patients with MPN are at increased risk of HF. Additionally, pre-clinical murine models harboring the JAK2 mutation, the most common driver mutation in MPNs, have shown accelerated adverse cardiac remodeling in myocardial infarction and pressure overload HF models. However, clinical outcomes, including in-hospital and readmission outcomes, of patients with MPN admitted for HF have not been well characterized. Methods: Patients hospitalized for HF with and without MPN were identified using the 2017 and 2018 National Readmission Database. Propensity score matching (PSM) was performed to match 1 MPN with 10 non-MPN controls. Outcomes were in-hospital death, 90-day CV-related, HF-related, and all-cause readmissions. Logistic regression and Cox proportional hazards regression models were used to estimate risk of in-hospital death and 90-day readmission outcomes, respectively. Results: After PSM, 4,626 patients with MPN were matched with 46,260 without. Patients with MPN were associated with increased risk of in-hospital death (OR 1.17, 95% CI 1.00 – 1.35), 90-day CV-related (HR 1.10, 95% CI 1.02 – 1.18) and all-cause (HR 1.24, 95% CI 1.17 – 1.31) but not HF-related (HR 1.05, 95% CI 0.97 – 1.14) readmissions. Conclusion: Among patients hospitalized for HF, MPN was associated with increased risk of in-hospital death, and 90-day CV-related readmissions (driven primarily by thrombotic readmissions). Further investigation is needed in order to improve outcomes in patients with MPN and HF.http://www.sciencedirect.com/science/article/pii/S2352906723001355Heart failureMyeloproliferative neoplasmsCardio-oncologyOutcomes |
| spellingShingle | Orly Leiva Jose Alvarez-Cardona Joan How Andrew Brunner Gabriela Hobbs In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database International Journal of Cardiology: Heart & Vasculature Heart failure Myeloproliferative neoplasms Cardio-oncology Outcomes |
| title | In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database |
| title_full | In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database |
| title_fullStr | In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database |
| title_full_unstemmed | In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database |
| title_short | In-Hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure: Insights from the National Readmissions Database |
| title_sort | in hospital and readmission outcomes of patients with myeloproliferative neoplasms and heart failure insights from the national readmissions database |
| topic | Heart failure Myeloproliferative neoplasms Cardio-oncology Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723001355 |
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