Carotid Artery Stiffness, Digital Endothelial Function, and Coronary Calcium in Patients with Essential Thrombocytosis, Free of Overt Atherosclerotic Disease

Matjaz Vrtovec, Ajda Anzic, Irena Preloznik Zupan, Katja Zaletel, Ales Blinc, Matjaz Vrtovec, Ajda Anzic, Irena Preloznik Zupan, Katja Zaletel, Ales Blinc

Abstract

Background: Patients with myeloproliferative neoplasms (MPNs) are at increased risk for atherothrombotic events. Our aim was 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.

Patients and methods: 40 ET patients without overt vascular disease, and 42 apparently healthy, age and sex-matched control subjects with comparable classical risk factors for atherosclerosis and Framingham risk of coronary disease were enrolled. All subjects were examined by physical and laboratory testing, carotid echo-tracking ultrasound, digital EndoPat pletysmography and CT coronary 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], β- 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 (0.62), p=0.07], or augmentation index [19 (3-30) vs. 13 (5-22) %, p=0.38]. Overall coronary calcium burden 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 endothelial function or overall coronary calcium score. Significantly more ET patients had an elevated coronary calcium score of >160, indicating high cardiovascular risk, not predicted by the Framingham equation.

Keywords: Framingham risk score; arterial wall; calcium score; functional properties; morphological properties; myeloproliferative disease.

Conflict of interest statement

Disclosure: No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1
Recruitment of essential thrombocytosis (ET) and control subjects for the cross-sectional study of endothelial function and preclinical atherosclerosis.
Figure 2
Figure 2
Correlation of the Framingham coronary heart disease (CHD) risk and coronary calcification (Agatston score). While a significant Pearson correlation between the Framingham CHD risk and the Agatston score was found for control subjects (r = 0.577, p

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