CAROTID ARTERY STIFFNESS, DIGITAL ENDOTHELIAL FUNCTION, AND CORONARY CALCIUM IN PATIENTS WITH ESSENTIAL THROMBOCYTOSIS, FREE OF OVERT ATHEROSCLEROTIC DISEASE

Abstract

Background. Patients with myeloproliferative neoplasms (MPNs) often suffer atherothrombotic events.

Aim. To determine, if patients with essential thrombocytosis (ET), a subtype of MPNs, free of symptomatic atherosclerosis, have greater carotid artery stiffness, worse endothelial function, greater coronary calcium and carotid plaque burden than control subjects.

Pateints and methods. 40 ET patients without overt vascular disease, and 41 apparently healthy, age and sex-matched control subjects with comparable classical risk factors for atheroscklerosis and Framingham risk for coronary disease were enrolled. All subjects were examined by physical and laboratory testing, carotid echo-tracking ultrasound, digital EndoPat pletysmography and CT calcium scoring.

Results. No significant differences were found between ET patients and controls in carotid plaque score (1 (0-1.25) vs. 0(0-2), p=0.30), beta-index of carotid stiffness (7.75(2.33) vs. 8.44(2.81), p=0.23), pulse wave velocity (6.21(1.00) vs. 6.45(1.04) m/s, p=0.46), digital reactive hyperemia index (2.10(0.57) vs. 2.35 (0.61), p=0.07), or augmentation index (19(3-30) vs. 13 (5-22)%, p=0.38). Overall calcium score did not differ between groups (Agatston score 0.1(0-16.85) vs. 0(0-8.55), p=0.26). However, significantly more ET patients had an elevated coronary calcium score of>160 (6/40 vs. 0/42, p<0.01).

Conclusions. No significant differences between groups were found in carotid artery morphology and function, digital endotheliel function or coronary calcium score. Significantly more ET patients had an elevatedcoronary calcium score of >160, indicating high cardiovascular risk, not predicted by the Framingham equation.