title: Anagrelide treatment and cardiovascular monitoring in essential thrombocythemia. A prospective observational study.
abstract: In this prospective observational single-center study, 55 patients with essential thrombocythemia who were candidates for second line treatment with anagrelide (ANA) received a preliminary cardiovascular (CV) clinical, instrumental and biochemical evaluation (CV history and symptoms, CV risk factors, blood pressure, heart rate, ECG and ECHO-cardio parameters, Troponin I, NT-proBNP). After this in-depth CV screening, 54 out of 55 patients were deemed to be fit for ANA treatment. Thirty-eight of the 55 patients received ANA treatment for a median of 36 months (range 3-48), and were monitored using the same CV evaluation. Fourteen of these 38 patients manifested CV adverse events (10 palpitation, 4 edema, 2 arterial hypertension, 2 acute myocardial infarction) that were not predicted by the in-depth CV evaluation, and that led to ANA withdrawal in only one case (non-cardiac refractory edema). In conclusion, the planned in-depth CV evaluation did not appear to be necessary in ET patients to evaluate their suitability for ANA treatment, and, moreover, was not able to predict the occurrence of CV adverse events during ANA treatment. Nevertheless, the CV adverse events (mostly palpitations and edema) were easily managed by the hematologists, and required the cardiologist involvement in very few selected cases.
authors: Cardiology Unit, Azienda Ospedaliera Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors: Giovanni
authors: G
authors: Tortorella
authors: Hematology Department, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy.
authors: Andrea
authors: A
authors: Piccin
authors: Hematology Department, Azienda Ospedaliera Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors: Alessia
authors: A
authors: Tieghi
authors: Clinical and Public Health Medicine Department, University of Modena and Reggio Emilia, Modena, Italy.
authors: Luigi
authors: L
authors: Marcheselli
authors: Hematology and Oncology Department, Medical University of Innsbruck, Innsbruck, Austria.
authors: Michael
authors: M
authors: Steurer
authors: Hematology and Oncology Department, Medical University of Innsbruck, Innsbruck, Austria.
authors: Günther
authors: G
authors: Gastl
authors: Hematology Department, Azienda Ospedaliera Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors: Katia
authors: K
authors: Codeluppi
authors: Hematology Department, Azienda Ospedaliera Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors: Angelo
authors: A
authors: Fama
authors: Statistics Department, University of Bologna, Bologna, Italy.
authors: Umberto
authors: U
authors: Santoro
authors: Internal Medicine Department, S. Orsola-Malpighi University Hospital, Bologna, Italy.
authors: Chiara
authors: C
authors: Birtolo
authors: Hematology Institute "L. e A. Seragnoli", S. Orsola-Malpighi University Hospital, Bologna, Italy.
authors: Gabriele
authors: G
authors: Gugliotta
authors: Hemato-Oncology Department, Institute Humanitas Gavazzeni, Bergamo, Italy.
authors: Sergio
authors: S
authors: Cortelazzo
authors: Hematology Institute "L. e A. Seragnoli", S. Orsola-Malpighi University Hospital, Bologna, Italy. Electronic address: luigi.gugliotta@unibo.it.
authors: Luigi
authors: L
authors: Gugliotta
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control; D004562:Electrocardiography; D005500:Follow-Up Studies; D008991:Monitoring, Physiologic; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects; D013920:Thrombocythemia, Essential / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D019210:Troponin I / Q000097:blood
chemical_list: C021139:anagrelide; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; C109794:pro-brain natriuretic peptide (1-76); D011799:Quinazolines; D019210:Troponin I
keywords: Anagrelide; Cardiovascular adverse events; Cardiovascular evaluation; Edema; Essential thrombocythemia; Palpitation