Risk of Cardiovascular and Cerebrovascular Diseases in Patients with Myeloid Neoplasms: Results from 1.8 Million Inhabitants of Northwest Italy

Background: Myeloid neoplasms are a group of pathologies characterized by clonal hematopoiesis and genetic mutations, often associated with inflammation and cardiovascular (CV) risk. While targeted therapies have improved prognosis, they may also lead to CV adverse effects. The aim was to analyze the risk of developing cardiovascular or cerebrovascular (CVD) events in patients who received a diagnosis of myeloid neoplasm, considering four subgroups of myeloid neoplasms: Chronic Myeloid Leukemia (CML), Myeloproliferative Neoplasm (MPN), Myelodysplastic Syndromes (MDS), and Acute Myeloid Leukemia (AML). Methods: Data was obtained from the Piedmont Longitudinal Study, including all subjects present in the census conducted in October 2011 and who were 40-80 years old. The association between myeloid neoplasms and cardiovascular and/or cerebrovascular diseases was evaluated through Competing Risks analyses, both on the entire sample and considering 40-64- and 65-80-years old subgroups. Results: Out of 1,795,216 subjects, 1,395 received a diagnosis of myeloid neoplasm and 82,978 experienced CVDs. Patients with myeloid neoplasms exhibited different CVD risks. In the younger population, CLM resulted associated with cerebrovascular events and MDS with myocardial infarction. In the older patients, CML was associated with heart failure, AML with CVD events, MDS with cardiovascular, particularly heart failure and peripheral vascular disease, and cerebrovascular events, while MPN with cardiovascular events, especially peripheral vascular disease. Conclusions: The results highlighted the importance of implementing a specific CVD prevention and surveillance plan for patients with myeloid neoplasms. Impact: Study evidence underlines which myeloid neoplasm patient subgroups require increased attention and monitoring to prevent future CVD events.