Abstract Number: OC 53.1
Meeting: ISTH 2021 Congress
Background: Thrombotic thrombocytopenic purpura (TTP) survivors have a two-fold higher mortality rate than age and sex-matched controls. Cardiovascular disease is a leading cause of death, but the epidemiology of major adverse cardiovascular events (MACE) in TTP has not been studied.
Aims: Determine the epidemiology and risk factors for MACE in TTP survivors.
Methods: Patients with TTP treated at Johns Hopkins Hospital from 1992 to 2020 with at least 3 months of follow up were included in the analysis. MACE was defined as the composite of non-fatal or fatal myocardial infarction (MI), stroke, and cardiac revascularization. Cox regression analysis was used to evaluate risk factors for MACE during clinical remission (normal platelet count and no symptoms of TTP).
Results: Of 158 patients with TTP, 122 were followed for ≥ 3 months and were included in the analysis. 69.7% were female. Median age at enrollment was 40.8 (IQR [interquartile range] 29.1, 54.0) years. Median follow up was 5.6 (IQR 2.4, 10.6) years. Cohort characteristics are summarized in Table 1.
Diabetes mellitus [HR 3.48 (95% CI 1.39, 8.69); P=0.008], age [HR 1.04 (95% CI 1.01,1.07); P= 0.012] and autoimmune disease [HR 2.55 (95% CI 1.04, 6.26) P= 0.041] were associated with MACE in a model also adjusted for sex, race, obesity, hypertension, HLD, and CKD (figure 1).
Conclusions: TTP Survivors experience high rates of MACE. Increasing age, diabetes mellitus, and autoimmune disease are associated with MACE risk. Our results highlight the need to screen and aggressively manage cardiovascular risk factors in TTP survivors.
To cite this abstract in AMA style:Brodsky M, Selvakumar S, Yanek L, Hussain S, Moliterno A, Brodsky R, Chaturvedi S. Major Adverse Cardiovascular Events Are a Major Cause of Morbidity after Recovery from Immune Thrombotic Thrombocytopenic Purpura [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/major-adverse-cardiovascular-events-are-a-major-cause-of-morbidity-after-recovery-from-immune-thrombotic-thrombocytopenic-purpura/. Accessed November 28, 2021.
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