PATIENTS with myeloproliferative neoplasms (MPN) undergoing percutaneous coronary intervention (PCI) face heightened risks of acute kidney injury (AKI) and blood transfusions compared to non-MPN patients, though in-hospital mortality and bleeding rates remain comparable, according to a National Inpatient Sample analysis of 2.24 million PCI hospitalizations.
MPNs, including essential thrombocythemia (ET), polycythemia vera (PV), chronic myeloid leukemia (CML), and primary myelofibrosis (PMF), are linked to elevated cardiovascular risks. This study analyzed 2,237,210 PCI admissions (2016–2020), identifying 7,560 (0.27%) MPN cases. Patients with MPN exhibited higher baseline cardiovascular comorbidities than non-MPN counterparts. Propensity score matching revealed significantly increased odds of AKI (OR: 1.39; 95% CI: 1.17–1.65; p < 0.001) and blood transfusions (OR: 1.66; 95% CI: 1.22–2.24; p = 0.001) in the MPN group. However, in-hospital mortality (OR: 1.18; 95% CI: 0.83–1.69; p = 0.354) and bleeding (OR: 1.43; 95% CI: 0.90–2.27; p = 0.127) did not differ significantly between groups. Among MPN subtypes, ET accounted for 53.2% of cases, followed by PV (24.2%), CML (19.6%), and PMF (3.0%), with no temporal shifts in prevalence (p = 0.12).
These findings highlight the need for vigilant post-PCI monitoring of MPN patients for renal complications and anemia management. The stable prevalence of MPN among PCI admissions over five years underscores persistent cardiovascular risks in this population. While mortality parity suggests current PCI protocols are equally effective for MPN patients, the elevated AKI and transfusion risks may reflect MPN-related hematologic dysregulation (e.g., thrombocytosis) or treatment effects (e.g., anticoagulant use). Clinicians should prioritize preprocedural risk stratification, optimize hydration, and consider tailored antiplatelet regimens to mitigate complications. Future research should investigate biologic mechanisms driving these disparities and evaluate interventions to improve outcomes in this high-risk subgroup.
Reference
Ang SP et al. Trends and outcomes following percutaneous coronary intervention in patients with myeloproliferative neoplasms: insights from National Database. Catheterization and Cardiovascular Interventions. 2025;DOI:10.1002/ccd.31489.
