Abstract Number: PB0056
Meeting: ISTH 2020 Congress
Theme: Arterial Thromboembolism » Cardiovascular Risk Factors
Background: Cardiovascular events emerge as a major cause of morbidity and mortality among allogeneic hematopoietic cell transplantation (alloHCT) survivors. Platelet and endothelial dysfunction complicate HCT. Nevertheless, it has been scarcely investigated whether these processes persist long after HCT, subsequently predisposing to cardiovascular events.
Aims: We investigated whether platelet and endothelial dysfunction are evident in alloHCT survivors using subtle markers indicative of subclinical dysfunction.
Methods: We enrolled consecutive adult alloHCT survivors from our HCT Clinic (January-December 2019). We excluded patients with established cardiovascular disease, chronic graft-versus-host disease under immunosuppressive treatment (GVHD), active malignancy or relapse. We also enrolled consecutive otherwise healthy control individuals from our Hypertension Clinic, matched for traditional cardiovascular risk factors (age, hypertension, diabetes, dyslipidemia, obesity, smoking). Detailed history, physical examination and blood sampling were performed. Subclinical cardiovascular damage was assessed by pulse-wave velocity (PWV)and carotid intima-media thickness (IMT). Platelet activation was evaluated by measurement of platelet microvesicles (PMVs) as previously published. Endothelial dysfunction was dynamically assessed by Laser Speckle Contrast Analysis (LASCA), evaluating microvascular blood flow of the skin forearm following ischemic occlusion (PeriCam PSI NR System, Perimed Järfälla, Sweden).
Results: We studied 45 patients after a median of 2.3 (range 1.1-13.2) years from alloHCT, the majority of whom had suffered from acute (44%) and/or chronic GVHD (66%), and 45 controls. Traditional cardiovascular risk factors and surrogate markers of cardiovascular disease did not differ between groups (Figure). Nevertheless, alloHCT survivors showed significantly increased PMVs and altered indices of endothelial dysfunction assessed with LASCA. 
[Baseline characteristics, surrogate markers of cardiovascular disease and indices of platelet and endothelial dysfunction in alloHCT survivors and mat]
In alloHCT survivors, PMVs were significantly associated with base to peak change (r=0.321, p=0.046).
Conclusions: Endothelial and platelet dysfunction are present in alloHCT survivors long after HCT, independently of traditional cardiovascular risk assessment. An apparent synergism exists that may be strongly implicated in the subsequent establishment of cardiovascular disease in these patients.
To cite this abstract in AMA style:
Gavriilaki E, Gkaliagkousi E, Sakellari I, Batsis I, Vardi A, Lazaridis A, Anyfanti P, Nikolaidou B, Zarifis I, Masmanidou M, Yiannaki E, Markala D, Douma S, Anagnostopoulos A. Crosstalk between Platelet and Endothelial Dysfunction in Survivors of Allogeneic Hematopoietic Cell Transplantation Independently of Traditional Cardiovascular Risk Assessment [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/crosstalk-between-platelet-and-endothelial-dysfunction-in-survivors-of-allogeneic-hematopoietic-cell-transplantation-independently-of-traditional-cardiovascular-risk-assessment/. Accessed September 24, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/crosstalk-between-platelet-and-endothelial-dysfunction-in-survivors-of-allogeneic-hematopoietic-cell-transplantation-independently-of-traditional-cardiovascular-risk-assessment/