Patients With CML, Acute Heart Failure Have Higher Hospitalization Rates

Patients with chronic myeloid leukemia (CML) and acute heart failure (AHF) are more likely to be hospitalized than the general population, according to a study presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

The investigators used data from the National Inpatient Sample database from 2018–2021, identifying adults with AHF among CML admissions. Patients were propensity matched by gender and race, with multivariate regression adjusting for sociodemographic factors and comorbidities.

Data from 23,559 patients with CML were included in the study. Overall, 149 (0.6%) patients had CML and AHF; in the general population of patients without CML, the rate of AHF was 0.4%. Stratifying by HF subtype, 32 (21.5%) patients had systolic HF, 77 (51.7%) had diastolic HF, and 23 (15.4%) had combined HF. Patients with CML and AHF had statistically higher hospital admission rates (P<0.001).

Several factors were associated with a significantly higher rate of AHF, captured via adjusted odds ratio (aOR):

• Age ≥65 years (aOR, 2.8; 95% CI, 1.8–4.3)
• Arrhythmia (aOR, 1.8; 95% CI, 1.2–2.7)
• Cardiogenic shock (aOR, 3.5; 95% CI, 1.3–9.4).

Meanwhile, the following factors were associated with a lower risk of AHF in patients with CML:

• Hypertension (aOR, 0.3; 95% CI, 0.1–0.5)
• Sepsis (aOR, 0.1; 95% CI, 0.0–0.5)
• Blood transfusion (aOR, 0.4; 95% CI, 0.2–0.7)

Among patients with CML, the odds of mortality for patients hospitalized for AHF were lower than the mortality rate for all-cause admissions (aOR, 0.1; 95% CI, 0.0–0.4; P≤0.001). Hospital costs and length of stay were also significantly lower in patients with CML hospitalized for AHF versus all-cause admissions (P≤0.01).

“AHF results in higher hospitalization rates in CML patients compared to the general hospital population. Our cross-sectional design limits us from exploring the reasons behind this,” the authors wrote. “These patients require close monitoring to reduce hospitalizations. However, AHF is associated with lower mortality, reduced hospital charges, and shorter hospital stays.”

Reference

Sivasubramanian BP, Saravanabavanandan R, Ravikumar DB, et al. Impact of acute heart failure in chronic myeloid leukemia (CML): propensity-matched analysis of National Inpatient Sample. Abstract #CML-486. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; Sept. 4-7, 2024; Houston, Texas.