Risk and timing of cardiovascular death among patients with myelodysplastic syndromes
Open accessAbstract
Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders associated with progression to leukemia and poor survival. Clonal hematopoiesis in people without an MDS diagnosis carries an increased risk of cardiovascular death. Many clonally restricted mutations are shared between patients with MDS and those with non-MDS clonal hematopoiesis; therefore, we evaluated the risk of cardiovascular death among patients with MDS. We evaluated adults with MDS in the Surveillance, Epidemiology, and End Results database of the National Cancer Institute and compared them with the general population living in the same states. We grouped histological subtypes of MDS into lower-, intermediate-, and higher-risk disease. The primary outcomes were overall survival and primary cause of death (COD) as reported to state registries. A total of 21 372 patients with MDS between 2001 and 2011 died during follow-up with a known COD. The rate of death due to cardiovascular disease (CVD) was 4613 per 100 000 person-years, compared with 2091 in the age- and-sex-adjusted US population (standardized mortality ratio, 2.21). At 24 months, the cumulative incidence of death attributed to MDS or leukemia was 23% vs 8% for CVD. Among those alive at 60 months, 27% eventually died of CVD compared with 29% from MDS or leukemia; those with lower-risk disease who survived >60 months had more deaths attributed to cardiovascular causes (30%; 95% confidence interval [CI], 26.7-33.2%) than MDS itself (24%; 95% CI, 21.4-27.5%). Patients with MDS are more likely to die of cardiovascular causes than the general population. Modifying cardiovascular risk factors, especially among those with lower-risk disease, may be warranted for MDS-related clinical care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Lower-risk subtypes of MDS are associated with a doubling of the risk of dying from cardiovascular causes.
“Just as CHIP is associated with an increased risk of cardiovascular disease, lower-risk subtypes of MDS are also associated with a doubling of the risk of dying from cardiovascular causes 80.”
From Clonal hematopoiesis in human aging and disease (2019) · cites this paper as [80]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
A Proportional Hazards Model for the Subdistribution of a Competing Risk
Fine, J. P., & Gray, R. J. (1999) · Journal of the American Statistical Association · doi:10.1080/01621459.1999.10474144 · Cited by 14,290 · cited 1× · see citing works
“Statistical analysis The incidence of a given COD among MDS patients was estimated using the cumulative incidence method; for each COD we investigated, all other CODs were considered to be competing risks.(21) COD was also explored according to each MDS risk group.”
MethodAge-related clonal hematopoiesis associated with adverse outcomes
Jaiswal, S., Fontanillas, P., Flannick, J., Manning, A., Grauman, P. V., Mar, B. G., Lindsley, R. C., Mermel, C. H., Burtt, N., Chavez, A., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1408617 · Cited by 4,841 · see citing works
Self-citationInternational scoring system for evaluating prognosis in myelodysplastic syndromes
Greenberg, P., Cox, C., LeBeau, M. M., Fenaux, P., Morel, P., Sanz, G., Sanz, M., Vallespi, T., Hamblin, T., Oscier, D., et al. (1997) · Blood · doi:10.1182/blood.v89.6.2079 · Cited by 4,427 · see citing works
Clonal hematopoiesis and blood-cancer risk inferred from blood DNA sequence
Genovese, G., Kähler, A. K., Handsaker, R. E., Lindberg, J., Rose, S. A., Bakhoum, S. F., Chambert, K., Mick, E., Neale, B. M., Fromer, M., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1409405 · Cited by 3,531 · see citing works
Revised International Prognostic Scoring System for Myelodysplastic Syndromes
Greenberg, P. L., Tuechler, H., Schanz, J., Sanz, G. F., Garcia‐Manero, G., Solé, F. G., Bennett, J. M., Bowen, D., Fenaux, P., Dreyfus, F., et al. (2012) · Blood · doi:10.1182/blood-2012-03-420489 · Cited by 3,181 · see citing works
Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease
Jaiswal, S., Natarajan, P., Silver, A. J., Gibson, C. J., Bick, A. G., Shvartz, E., McConkey, M., Gupta, N., Gabriel, S., Ardissino, D., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1701719 · Cited by 2,683 · see citing works
Self-citationClonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes
Steensma, D. P., Bejar, R., Jaiswal, S., Lindsley, R. C., Sekeres, M. A., Hasserjian, R. P., & Ebert, B. L. (2015) · Blood · doi:10.1182/blood-2015-03-631747 · Cited by 1,971 · see citing works
Self-citationClonal hematopoiesis associated with TET2 deficiency accelerates atherosclerosis development in mice
Fuster, J. J., MacLauchlan, S., Zuriaga, M. A., Polackal, M. N., Ostriker, A. C., Chakraborty, R., Wu, C.-L., Sano, S., Muralidharan, S., Rius, C., et al. (2017) · Science · doi:10.1126/science.aag1381 · Cited by 1,536 · see citing works
Somatic<i>SF3B1</i>Mutation in Myelodysplasia with Ring Sideroblasts
Papaemmanuil, E., Cazzola, M., Boultwood, J., Malcovati, L., Vyas, P., Bowen, D., Pellagatti, A., Wainscoat, J. S., Hellstrom-Lindberg, E., Gambacorti-Passerini, C., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1103283 · Cited by 1,222 · see citing works
(2012) · The Lancet · doi:10.1016/s0140-6736(12)60110-x · Cited by 1,146 · see citing works
Malcovati, L., Porta, M. G. D., Pascutto, C., Invernizzi, R., Boni, M., Travaglino, E., Passamonti, F., Arcaini, L., Maffioli, M., BERNASCONI, P. P., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.01.7038 · Cited by 867 · see citing works
Ma, X., Does, M. B., Raza, A., & Mayne, S. T. (2007) · Cancer · doi:10.1002/cncr.22570 · Cited by 537 · see citing works
SF3B1 mutation identifies a distinct subset of myelodysplastic syndrome with ring sideroblasts
Malcovati, L., Karimi, M., Papaemmanuil, E., Ambaglio, I., Jädersten, M., Jansson, M., Elena, C., Gallì, A., Walldin, G., Della Porta, M. G., et al. (2015) · Blood · doi:10.1182/blood-2015-03-633537 · Cited by 434 · see citing works
Preleukaemic clonal haemopoiesis and risk of therapy-related myeloid neoplasms: a case-control study
Takahashi, K., Wang, F., Kantarjian, H., Doss, D., Khanna, K., Thompson, E., Zhao, L., Patel, K., Neelapu, S., Gumbs, C., et al. (2017) · The Lancet Oncology · doi:10.1016/s1470-2045(16)30626-x · Cited by 399 · see citing works
Kwok, B., Hall, J., Witte, J. S., Xu, Y., Reddy, P., Lin, K., Flamholz, R., Dabbas, B., Yung, A., Al-Hafidh, J., et al. (2015) · Blood · doi:10.1182/blood-2015-08-667063 · Cited by 317 · see citing works
Gillis, N. K., Ball, M., Zhang, Q., Ma, Z., Zhao, Y., Yoder, S. J., Balasis, M. E., Mesa, T. E., Sallman, D. A., Lancet, J. E., et al. (2017) · The Lancet Oncology · doi:10.1016/s1470-2045(16)30627-1 · Cited by 317 · see citing works
Jädersten, M., Malcovati, L., Dybedal, I., Porta, M. G. D., Invernizzi, R., Montgomery, S., Pascutto, C., Porwit‐MacDonald, A., Cazzola, M., & Hellström‐Lindberg, E. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.4906 · Cited by 299 · see citing works
Goldberg, S. L., Chen, E., Corral, M., Guo, A. X., Mody‐Patel, N., Pecora, A. L., & Laouri, M. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2009.25.2395 · Cited by 289 · see citing works
Interleukin-6 and Cardiovascular Diseases
Kanda, T., & Takahashi, T. (2004) · Japanese Heart Journal · doi:10.1536/jhj.45.183 · Cited by 265 · see citing works
The incidence and impact of thrombocytopenia in myelodysplastic syndromes
Kantarjian, H. M., Giles, F. J., List, A. F., Lyons, R. M., Sekeres, M. A., Pierce, S. A., Deuson, R. R., & Leveque, J. A. (2007) · Cancer · doi:10.1002/cncr.22602 · Cited by 251 · see citing works
Sekeres, M. A., Schoonen, W. M., Kantarjian, H., List, A., Fryzek, J., Paquette, R., & Maciejewski, J. P. (2008) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/djn349 · Cited by 248 · see citing works
SF3B1, a splicing factor is frequently mutated in refractory anemia with ring sideroblasts
Visconte, V., Makishima, H., Jankowska, A. M., Szpurka, H., Traina, F., Jerez, A., O'Keefe, C., Rogers, H. J., Sekeres, M. A., Maciejewski, J. P., et al. (2011) · Leukemia · doi:10.1038/leu.2011.232 · Cited by 212 · see citing works
Cause of death in patients with lower‐risk myelodysplastic syndrome
Dayyani, F., Conley, A. P., Strom, S. S., Stevenson, W. S., Cortes, J. E., Borthakur, G. M., Faderl, S. H., O'Brien, S. M., Pierce, S. A., Kantarjian, H. M., et al. (2010) · Cancer · doi:10.1002/cncr.24984 · Cited by 180 · see citing works
Time-dependent changes in mortality and transformation risk in MDS
Pfeilstöcker, M., Tuechler, H., Sanz, G. F., Schanz, J., Garcia‐Manero, G., Solé, F. G., Bennett, J. M., Bowen, D., Fenaux, P., Dreyfus, F., et al. (2016) · Blood · doi:10.1182/blood-2016-02-700054 · Cited by 179 · see citing works
Targeted sequencing identifies patients with preclinical MDS at high risk of disease progression
Cargo, C. A., Rowbotham, N. J., Evans, P., Barrans, S., Bowen, D., Crouch, S., & Jack, A. (2015) · Blood · doi:10.1182/blood-2015-08-663237 · Cited by 178 · see citing works
Recent developments in myelodysplastic syndromes
Bejar, R. L., & Steensma, D. P. (2014) · Blood · doi:10.1182/blood-2014-04-522136 · Cited by 173 · see citing works
Self-citationThe WHO classification of MDS does make a difference
Howe, R. B., Porwit‐MacDonald, A., Wanat, R., Tehranchi, R., & Hellström-Lindberg, E. (2003) · Blood · doi:10.1182/blood-2003-06-2124 · Cited by 147 · see citing works
Infections in myelodysplastic syndromes
Toma, A., Fenaux, P., Dreyfus, F., & Cordonnier, C. (2012) · Haematologica · doi:10.3324/haematol.2012.063420 · Cited by 119 · see citing works
Objectives of iron chelation therapy in myelodysplastic syndromes: more than meets the eye?
Pullarkat, V. A. (2009) · Blood · doi:10.1182/blood-2009-07-234062 · Cited by 108 · see citing works
Causes of death in 2877 patients with myelodysplastic syndromes
Nachtkamp, K., Stark, R., Strupp, C., Kündgen, A., Giagounidis, A. A. N., Aul, C., Hildebrandt, B., Haas, R. R., Gattermann, N., & Germing, U. (2016) · Annals of Hematology · doi:10.1007/s00277-016-2649-3 · Cited by 95 · see citing works
Wang, R., Gross, C. P., Halene, S., & Ma, X. (2009) · Leukemia Research · doi:10.1016/j.leukres.2009.02.005 · Cited by 90 · see citing works
cmprsk: Subdistribution Analysis of Competing Risks
<gray@jimmy.harvard.edu>, B. G. (2001) · doi:10.32614/cran.package.cmprsk · Cited by 89 · see citing works
Pardanani, A. D., Finke, C. M., Lasho, T. L., Al‐Kali, A., Begna, K. H., Hanson, C. A., & Tefferi, A. (2011) · Leukemia · doi:10.1038/leu.2011.251 · Cited by 81 · see citing works
Iron Overload in Allogeneic Hematopoietic Cell Transplantation Outcome: A Meta-Analysis
Armand, P. A., Kim, H. T., Virtanen, J. M., et al. (2014) · Transplantation and Cellular Therapy · doi:10.1016/j.bbmt.2014.04.024 · Cited by 80 · see citing works
Lund, J. L., Harlan, L. C., Yabroff, K. R., & Warren, J. L. (2010) · Cancer Investigation · doi:10.3109/07357901003630959 · Cited by 67 · see citing works
Graphical representation of clinical outcomes for patients with myelodysplastic syndromes
Steensma, D. P. (2015) · Leukemia & lymphoma/Leukemia and lymphoma · doi:10.3109/10428194.2015.1061191 · Cited by 28 · see citing works
Self-citationTall, A. R., & Levine, R. L. (2017) · Nature · doi:10.1038/nature21505 · Cited by 24 · see citing works
Epidemiology and risk factors for infections in myelodysplastic syndromes
Sullivan, L. R., Sekeres, M. A., Shrestha, N. K. M., et al. (2013) · Transplant Infectious Disease · doi:10.1111/tid.12130 · Cited by 23 · see citing works
Nine years without a new FDA-approved therapy for MDS: how can we break through the impasse?
Dezern, A. E. (2015) · Hematology · doi:10.1182/asheducation-2015.1.308 · Cited by 18 · see citing works
Ascertainment of Patients With Myelodysplastic Syndromes
Ma, X., & Wang, R. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2010.31.8287 · Cited by 10 · see citing works
Study of Causes of Death in Patients with Myelodysplastic Syndrome: A Single Institution Experience
Montoro, J., Vallespı́, T., Sancho, E., et al. (2011) · Blood · doi:10.1182/blood.v118.21.5026.5026 · Cited by 7 · see citing works
Mortality from myelodysplastic syndromes: A multiple causes of death approach
Fedeli, U., Schievano, E., Saugo, M., et al. (2014) · American Journal of Hematology · doi:10.1002/ajh.23671 · Cited by 6 · see citing works
Polednak, A. P. (2011) · PubMed · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Clonal hematopoiesis in human aging and disease
Jaiswal, S., & Ebert, B. L. (2019) · Science · doi:10.1126/science.aan4673 · Cited by 1,156 · see citing works
“Just as CHIP is associated with an increased risk of cardiovascular disease, lower-risk subtypes of MDS are also associated with a doubling of the risk of dying from cardiovascular causes (81).”
- Authors
- Brunner, A. M., Blonquist, T. M., Hobbs, G. S., Amrein, P. C., Neuberg, D. S., Steensma, D. P., Abel, G. A., & Fathi, A. T.
- Affiliations
- Massachusetts General Hospital (US)
- Department of Biostatistics and Computational Biology, and
- Harvard University (US)
- ORCID
- Venue
- Blood Advances
- Publisher
- American Society of Hematology
- Published
- 2017-10-18
- Volume
- 1
- Issue
- 23
- Pages
- 2032-2040
- ISSN
- 2473-9529 (ISSN-L)
- 2473-9537
- PMC
- PMC5728287
- OpenAlex
- W2766983664
- Cited by
- 63
- References
- 44
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 8 · 2020: 8 · 2019: 13 · 2018: 7
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Blood Advances (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Cancer Institute (P30CA006516)
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
- Keywords
- myelodysplastic syndrome, cardiovascular mortality, clonal hematopoiesis, clonal mutations, cardiovascular risk factors, disease risk stratification, overall survival, leukemia progression, mortality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
