TY - JOUR
T1 - Anagrelide treatment and cardiovascular monitoring in essential thrombocythemia. A prospective observational study
AU - Tortorella, Giovanni
AU - Piccin, Andrea
AU - Tieghi, Alessia
AU - Marcheselli, Luigi
AU - Steurer, Michael
AU - Gastl, Günther
AU - Codeluppi, Katia
AU - Fama, Angelo
AU - Santoro, Umberto
AU - Birtolo, Chiara
AU - Gugliotta, Gabriele
AU - Cortelazzo, Sergio
AU - Gugliotta, Luigi
PY - 2015/6/1
Y1 - 2015/6/1
N2 - In this prospective observational single-center study, 55 patients with essential thrombocythemia who were candidates for second line treatment with anagrelide (ANA) received a preliminary cardiovascular (CV) clinical, instrumental and biochemical evaluation (CV history and symptoms, CV risk factors, blood pressure, heart rate, ECG and ECHO-cardio parameters, Troponin I, NT-proBNP). After this in-depth CV screening, 54 out of 55 patients were deemed to be fit for ANA treatment. Thirty-eight of the 55 patients received ANA treatment for a median of 36 months (range 3-48), and were monitored using the same CV evaluation. Fourteen of these 38 patients manifested CV adverse events (10 palpitation, 4 edema, 2 arterial hypertension, 2 acute myocardial infarction) that were not predicted by the in-depth CV evaluation, and that led to ANA withdrawal in only one case (non-cardiac refractory edema). In conclusion, the planned in-depth CV evaluation did not appear to be necessary in ET patients to evaluate their suitability for ANA treatment, and, moreover, was not able to predict the occurrence of CV adverse events during ANA treatment. Nevertheless, the CV adverse events (mostly palpitations and edema) were easily managed by the hematologists, and required the cardiologist involvement in very few selected cases.
AB - In this prospective observational single-center study, 55 patients with essential thrombocythemia who were candidates for second line treatment with anagrelide (ANA) received a preliminary cardiovascular (CV) clinical, instrumental and biochemical evaluation (CV history and symptoms, CV risk factors, blood pressure, heart rate, ECG and ECHO-cardio parameters, Troponin I, NT-proBNP). After this in-depth CV screening, 54 out of 55 patients were deemed to be fit for ANA treatment. Thirty-eight of the 55 patients received ANA treatment for a median of 36 months (range 3-48), and were monitored using the same CV evaluation. Fourteen of these 38 patients manifested CV adverse events (10 palpitation, 4 edema, 2 arterial hypertension, 2 acute myocardial infarction) that were not predicted by the in-depth CV evaluation, and that led to ANA withdrawal in only one case (non-cardiac refractory edema). In conclusion, the planned in-depth CV evaluation did not appear to be necessary in ET patients to evaluate their suitability for ANA treatment, and, moreover, was not able to predict the occurrence of CV adverse events during ANA treatment. Nevertheless, the CV adverse events (mostly palpitations and edema) were easily managed by the hematologists, and required the cardiologist involvement in very few selected cases.
KW - Anagrelide
KW - Cardiovascular adverse events
KW - Cardiovascular evaluation
KW - Edema
KW - Essential thrombocythemia
KW - Palpitation
UR - http://www.scopus.com/inward/record.url?scp=84929515362&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929515362&partnerID=8YFLogxK
U2 - 10.1016/j.leukres.2015.03.014
DO - 10.1016/j.leukres.2015.03.014
M3 - Article
C2 - 25850727
AN - SCOPUS:84929515362
VL - 39
SP - 592
EP - 598
JO - Leukemia Research
JF - Leukemia Research
SN - 0145-2126
IS - 6
ER -