Estimated pulse wave velocity for MACE risk evaluation in ET and PV

Results from a retrospective single-center cohort study evaluating estimated pulse wave velocity (ePWV) as a marker of major adverse cardiovascular events (MACE) in 664 patients with myeloproliferative neoplasms (MPN) were published in the British Journal of Haematology by Costa et al. The primary objective of this study was to evaluate the association between ePWV and the risk of MACE, including arterial thrombosis, venous thromboembolism (VTE), hospitalization for heart failure, and cardiovascular death. 

Key data: The cohort included patients with essential thrombocythemia (ET; n = 477) or polycythemia vera (PV; n = 187). Median ePWV was 11.1 m/s and did not differ between ET and PV (p = 0.335); 72.1% of patients met the criteria for early vascular ageing (EVA; ePWV ≥9.4 m/s). At a median follow-up of 67.4 months, 58 first MACE and 58 deaths occurred. In multivariable cause-specific Cox models, each 1 m/s higher baseline ePWV was independently associated with a 16% higher hazard of MACE (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.02–1.32; p = 0.025) and a higher hazard of death from any cause (HR, 1.77; 95% CI, 1.52–2.07; p < 0.001). The adjusted HR per 1 m/s higher baseline ePWV was 1.12 (p = 0.123), 1.18 (p = 0.054), and 0.98 (p = 0.860) for overall thrombosis, arterial thrombosis, and VTE, respectively. Among patients with JAK2 mutations, JAK2 V617F variant allele frequency (VAF) showed a positive correlation with baseline ePWV (p = 0.022).

Key learning: In this study, ePWV represented a scalable marker of MACE risk in ET and PV, capturing clinically relevant information beyond traditional risk factors. Validation in prospective, multicenter studies is warranted to define the role of ePWV in risk stratification and prevention strategies.