In an international collaborative study, a central histologic review identified 891 patients with essential thrombocythemia, strictly defined byWorld Health Organization criteria. After a median follow-up of 6.2 years, 109 (12%) patients experienced arterial (n 79) or venous (n 37) thrombosis. In multivariable analysis, predictors of arterial thrombosis included age more than 60 years (P .03; hazard ratio [HR] 1.7), thrombosis history (P .003; HR 2.1), cardiovascular risk factors including tobacco use, hypertension, or diabetes mellitus (P .007; HR 1.9), leukocytosis (> 11 109/L; P .04; HR 1.7), and presence of JAK2V617F (P .009; HR 2.6). In contrast, only male gender predicted venous thrombosis. Platelet count more than 1000 109/L was associated with a lower risk of arterial thrombosis (P .007; HR 0.4). These associations, except the one with leukocytosis, remained significant (or near significant) whenanalysiswasrestricted toJAK2V617Fpositive cases. The current study clarifies the contribution of specific disease and host characteristics to the risk of arterial versus venous thrombosis in essential thrombocythemia.
Risk factors for arterial and venous thrombosis in WHO-defined essential thrombocythemia: an international study of 891 patients
RANDI, MARIA LUIGIA;BERTOZZI, IRENE;
2011
Abstract
In an international collaborative study, a central histologic review identified 891 patients with essential thrombocythemia, strictly defined byWorld Health Organization criteria. After a median follow-up of 6.2 years, 109 (12%) patients experienced arterial (n 79) or venous (n 37) thrombosis. In multivariable analysis, predictors of arterial thrombosis included age more than 60 years (P .03; hazard ratio [HR] 1.7), thrombosis history (P .003; HR 2.1), cardiovascular risk factors including tobacco use, hypertension, or diabetes mellitus (P .007; HR 1.9), leukocytosis (> 11 109/L; P .04; HR 1.7), and presence of JAK2V617F (P .009; HR 2.6). In contrast, only male gender predicted venous thrombosis. Platelet count more than 1000 109/L was associated with a lower risk of arterial thrombosis (P .007; HR 0.4). These associations, except the one with leukocytosis, remained significant (or near significant) whenanalysiswasrestricted toJAK2V617Fpositive cases. The current study clarifies the contribution of specific disease and host characteristics to the risk of arterial versus venous thrombosis in essential thrombocythemia.Pubblicazioni consigliate
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