KEY TAKEAWAYS
- The study aimed to investigate the association between DIC-complicating patients with AML and acute cardiovascular complications.
- Researchers noticed that close cardiovascular monitoring and prompt recognition are crucial; further investigation is ongoing.
Disseminated intravascular coagulation (DIC) is a common complication of all leukemia subtypes, but it is an especially prominent feature of Acute Myeloid Leukemias (AML). DIC complicating AML can lead to a variety of complications; however, its association with acute cardiovascular complications has not been reported before.
Ghada Araji and the team aimed to assess the association between DIC complicating AML and acute cardiovascular complications.
They performed an inclusive analysis using the National Inpatient Sample Database to procure individuals with AML. Baseline demographics and comorbidities were collected using ICD-10-DM codes. Patients were stratified into those with and without DIC.
Greedy propensity matching using R was performed to match the two cohorts in a 1:1 ratio based on age, gender, and 15 other baseline comorbidities. Univariate analysis pre- and post-match, along with binary logistic regression analysis post-match, were used to analyze outcomes.
About 37,344 patients with AML were included, of whom 996 had DIC. DIC patients were younger, predominantly male, and had a lower prevalence of baseline cardiovascular comorbidities. DIC patients had statistically significantly higher mortality (30.2% vs 7.8%), acute myocardial infarction (5.1% vs 1.8%), acute pulmonary edema (2.3% vs 0.7%), cardiac arrest (6.4% vs 0.9%), and acute DVT/PE (6.6% vs 2.7%). The logistic regression model, after matching, showed similar outcomes, along with significantly higher rates of acute heart failure in DIC patients.
The study concluded that close cardiovascular monitoring and prompt recognition of complications are crucial for AML patients with DIC. The underlying mechanisms involve a complex interplay of procoagulant factors, cytokine release, and endothelial dysfunction. Further studies are needed to develop targeted interventions for the prevention and management of these complications.
No funding information is given.
Source: https://pubmed.ncbi.nlm.nih.gov/38796899/
Araji G, Mustafa A, Niazi M, et al. (2024). “Acute cardiovascular complications of disseminated intravascular coagulation in acute myeloid leukemia.” Thromb Res. 2024 Jul;239:109042. doi: 10.1016/j.thromres.2024.109042. Epub 2024 May 24. PMID: 38796899.
