However, the risks among patients with breast or prostate cancer decreased during the 10 years after diagnosis. Relative risks (RRs) for CVD– and CVA–related mortality (adjusted for age, sex, and year) were:
- CMML: RR=2.98 (95% CI 2.69-3.29; p=0.6×10-90)
- MDS: RR=2.61 (95% CI 2.53-2.70; p<1×10-100)
- breast cancer: RR=0.99 (0.98-1.00; p=0.03)
- prostate cancer: RR=0.90 (95% CI 0.90-0.91; p<1×10-100)
Although the risks for CVD– and CVA–related mortality were highest during the first year after cancer diagnosis for patients with CMML and MDS, Dr. Molenaar noted, it remained elevated at two to three times the adjusted risk relative to the general population through 10 years after cancer diagnosis.
This evidence supports the conclusions of prospective case-control studies and the need for screening patients with newly diagnosed CMML and MDS for CVD, the authors concluded.
“When a patient is diagnosed, [they  should undergo] a cardiovascular work-up to see if anything can be managed,†Dr. Molenaar said. “Our data suggest that those patients can benefit from aggressive cardiovascular risk factor management.â€
Though this was a large, population-level analysis, he added, it was limited by the lack of “granular†data captured in the SEER database. Future analyses are evaluating smaller European registries that capture these data and will hopefully shed more light on the specific types of fatal cardiovascular events, he added.
The authors report no relevant conflicts of interest.
Reference
Molenaar RJ, Radivoyevitch T, Sekeres MA, et al. High rates of atherosclerotic disease-related mortality in myelodysplastic syndromes and chronic myelomonocytic leukemia patients associated with TET2-mutations. Abstract #421. Presented at the 2017 American Society of Hematology Annual Meeting, December 10, 2017; Atlanta, GA.