Cardiovascular Events Associated With Use of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: A Population-Based Cohort Study.
Ann Intern Med
; 165(3): 161-6, 2016 08 02.
Article
em En
| MEDLINE
| ID: mdl-27295519
ABSTRACT
BACKGROUND:
Tyrosine kinase inhibitors (TKIs) have increased survival dramatically for patients with chronic myeloid leukemia (CML), but continuous administration of these drugs may elicit long-term toxicity.OBJECTIVE:
To investigate the incidence of vascular events in patients with CML treated with first- and second-generation TKIs.DESIGN:
Retrospective cohort study using nationwide population-based registries.SETTING:
Sweden. PATIENTS All patients diagnosed with chronic-phase CML in Sweden from 2002 to 2012 and treated with a TKI, and 5 age- and sex-matched control individuals per patient. MEASUREMENTS Relative risks, expressed as incidence rate ratios comparing patients with control individuals, were calculated. Events per 1000 person-years were assessed in interdrug comparisons.RESULTS:
896 patients, 94.4% with documented TKI treatment, were followed for a median of 4.2 years. There were 54 arterial and 20 venous events in the CML cohort, corresponding to relative risks of 1.5 (95% CI, 1.1 to 2.1) and 2.0 (CI, 1.2 to 3.3), respectively. The event rate for myocardial infarction was higher in patients treated with nilotinib or dasatinib (29 and 19 per 1000 person-years, respectively) than in those receiving imatinib (8 per 1000 person-years), although data are limited and the CIs were wide and overlapped. Among 31 patients treated with a TKI who had myocardial infarction, 26 (84%) had at least 1 major cardiac risk factor diagnosed before the event occurred.LIMITATIONS:
Patients may have been exposed to multiple TKIs. Data on second- and third-generation TKIs were limited.CONCLUSION:
An increased risk for arterial and venous vascular events was seen in patients with CML treated with a TKI. Further study is needed to determine whether the risk for myocardial infarction increases with second-generation drugs. PRIMARY FUNDING SOURCE No external funding.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteínas Tirosina Quinases
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Doenças Cardiovasculares
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Leucemia Mieloide de Fase Crônica
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Antineoplásicos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Intern Med
Ano de publicação:
2016
Tipo de documento:
Article