Patients with MPNs at Higher Risk for Hospital Readmission After Afib

In patients with atrial fibrillation (Afib), myeloproliferative neoplasms (MPNs), including primary myelofibrosis, are associated with an increased risk of hospital readmissions for any cause, bleeding, and arterial thrombosis (AT), according to research presented at the 2023 American Society of Clinical Oncology Annual Meeting.

MPNs are associated with increased risk of cardiovascular disease, and patients with MPNs often have Afib as well. However, studies have not thoroughly explored outcomes regarding thrombotic and bleeding events in patients with MPNs, as compared to patients without MPNs.

The study extracted data from the National Readmission Database on 468,094 patients with AF, 1,617 of whom had a history of MPN. Inclusion criteria were ages older than 18 years and hospital admission for Afib in 2017 or 2018.

The researchers examined 30-and 90-day readmissions related to the following conditions:

• Any cause
• AT (including stroke, myocardial infarction, and arterial thromboembolism)
• Bleeding

They also collected CHA2DS2–VASc scores to calculate Afib stroke risk and HAS-BLED scores to estimate one-year risk of major bleeding events related to Afib. The scores were similar between patients with MPNs and those without (mean, CHA₂DS₂-VASC 3.8 vs 3.7; mean, HAS-BLED 2.4 vs 2.3). However, patients with MPNs had an increased risk of 30-day readmission due to any cause, AT, and bleeding. They also had an increased risk of 90-day readmissions due to any cause and bleeding—but not AT.

The findings indicate that risk scores may be improved by including data on MPN status, according to the authors.

“Further studies are needed to identify risk factors for bleeding and AT in patients with MPN and AF and improve on current risk scores, which do not include MPN status,” wrote the authors, led by Orly Leiva, MD, of the Grossman School of Medicine at New York University in New York, New York

Reference

Leiva O, How C-J, Brunner A, et al. Outcomes of patients with a myeloproliferative neoplasm and atrial fibrillation. Abstract #7070. Presented at the 2023 American Society of Clinical Oncology Annual Meeting; June 2-6, 2023; Chicago, Illinois.