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Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data.
Ann Hematol. 2019 Nov; 98(11):2533-2539.AH

Abstract

Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03-2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.

Authors+Show Affiliations

Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE, 19803, USA. sparasuraman@incyte.com.Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE, 19803, USA.Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE, 19803, USA.STATinMED Research, 5360 Legacy Dr Ste 120, Plano, TX, 75024, USA.STATinMED Research, 5360 Legacy Dr Ste 120, Plano, TX, 75024, USA.STATinMED Research, 5360 Legacy Dr Ste 120, Plano, TX, 75024, USA. Internal Medicine - Rheumatology, University of Michigan, 3918 TC, Ann Arbor, MI, 48109, USA. Department of Economics, MEF University, Ayazağa St. No.4 34396, Maslak, Sarıyer, Istanbul, Turkey.UT Health San Antonio MD Anderson Cancer Center, 7979 Wurzbach Rd, San Antonio, TX, 78229, USA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31552445

Citation

Parasuraman, Shreekant, et al. "Hematocrit Levels and Thrombotic Events in Patients With Polycythemia Vera: an Analysis of Veterans Health Administration Data." Annals of Hematology, vol. 98, no. 11, 2019, pp. 2533-2539.
Parasuraman S, Yu J, Paranagama D, et al. Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data. Ann Hematol. 2019;98(11):2533-2539.
Parasuraman, S., Yu, J., Paranagama, D., Shrestha, S., Wang, L., Baser, O., & Scherber, R. (2019). Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data. Annals of Hematology, 98(11), 2533-2539. https://doi.org/10.1007/s00277-019-03793-w
Parasuraman S, et al. Hematocrit Levels and Thrombotic Events in Patients With Polycythemia Vera: an Analysis of Veterans Health Administration Data. Ann Hematol. 2019;98(11):2533-2539. PubMed PMID: 31552445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data. AU - Parasuraman,Shreekant, AU - Yu,Jingbo, AU - Paranagama,Dilan, AU - Shrestha,Sulena, AU - Wang,Li, AU - Baser,Onur, AU - Scherber,Robyn, Y1 - 2019/09/24/ PY - 2019/06/04/received PY - 2019/08/29/accepted PY - 2019/9/26/pubmed PY - 2019/12/18/medline PY - 2019/9/26/entrez KW - Hematocrit KW - Polycythemia vera KW - Retrospective study KW - Thromboembolism KW - Thrombosis KW - Thrombotic event SP - 2533 EP - 2539 JF - Annals of hematology JO - Ann Hematol VL - 98 IS - 11 N2 - Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03-2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV. SN - 1432-0584 UR - https://www.unboundmedicine.com/medline/citation/31552445/Hematocrit_levels_and_thrombotic_events_in_patients_with_polycythemia_vera:_an_analysis_of_Veterans_Health_Administration_data_ L2 - https://dx.doi.org/10.1007/s00277-019-03793-w DB - PRIME DP - Unbound Medicine ER -