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高 JAK2V617F 变异等位基因频率与费城阴性骨髓增殖性肿瘤患者的冠状动脉钙化而非主动脉瓣钙化相关。

High JAK2V617F variant allele frequency is associated with coronary artery but not aortic valve calcifications in patients with Philadelphia-negative myeloproliferative neoplasms.

机构信息

Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.

Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

Eur J Haematol. 2023 Sep;111(3):400-406. doi: 10.1111/ejh.14019. Epub 2023 Jun 7.

Abstract

BACKGROUND

Patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) have a higher burden of cardiac calcifications compared to the general population. It is not known whether the JAK2V617F mutation is associated with increased cardiac calcification.

AIM

To investigate if a higher JAK2V617F variant allele frequency (VAF) is associated with severe coronary atherosclerosis and the presence of aortic valve calcification (AVC).

METHODS

Patients with MPNs were examined by cardiac computer tomography to establish coronary artery calcium score (CACS) and AVC score. The first VAF after diagnosis was registered. Severe coronary atherosclerosis was defined as a CACS >400 and AVC was defined as an AVC score >0.

RESULTS

Among 161 patients, 137 were JAK2V617F mutation-positive, with a median VAF of 26% (interquartile range 12%-52%). A VAF in the upper quartile range was associated with a CACS >400 [odds ratio (OR) 15.96, 95% confidence interval [CI] 2.13-119.53, p = .0070], after adjustment for cardiovascular risk factors and MPN subtype. An association was not found for the presence of AVC (OR 2.30, 95% CI 0.47-11.33, p = 0.31).

CONCLUSION

In patients with MPNs, there is a significant association between having a VAF in the upper quartile (>52%), and severe coronary atherosclerosis, defined as a CACS >400. The presence of AVC is not associated with VAF.

摘要

背景

与普通人群相比,费城阴性骨髓增殖性肿瘤(MPN)患者的心脏钙化负担更高。目前尚不清楚 JAK2V617F 突变是否与心脏钙化增加有关。

目的

研究较高的 JAK2V617F 变异等位基因频率(VAF)是否与严重冠状动脉粥样硬化和主动脉瓣钙化(AVC)的存在相关。

方法

对 MPN 患者进行心脏计算机断层扫描,以确定冠状动脉钙评分(CACS)和 AVC 评分。记录诊断后的第一个 VAF。严重冠状动脉粥样硬化定义为 CACS>400,AVC 定义为 AVC 评分>0。

结果

在 161 例患者中,有 137 例为 JAK2V617F 突变阳性,中位 VAF 为 26%(四分位距 12%-52%)。上四分位 VAF 与 CACS>400 相关[优势比(OR)15.96,95%置信区间(CI)2.13-119.53,p=0.0070],校正心血管危险因素和 MPN 亚型后。AVC 的存在与 VAF 之间未发现相关性(OR 2.30,95%CI 0.47-11.33,p=0.31)。

结论

在 MPN 患者中,VAF 处于较高四分位(>52%)与严重冠状动脉粥样硬化(定义为 CACS>400)之间存在显著相关性。AVC 的存在与 VAF 无关。

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