PV – hematocrit control and cardiovascular assessment
A recent presentation from MPN specialists Professor Jean-Jacques Kiladjian, Saint Louis Hospital, Paris, and Professor Claire Harrison, Guy’s and St Thomas’ NHS Foundation Trust from the UK discusses the importance of maintaining hematocrit control in patients with polycythemia vera (PV) as well as monitoring cardio-vascular health.
The discussion, part 1 of an expert roundtable series, is wide ranging and covers the risk factors for patients with polycythemia vera.
Of particular interest is the manner in which cardiovascular health is treated by Professor Kiladjian’s team in Paris.
Claire Harrison: “Jean-Jacques, we’ve recently been looking across some PV patients and thinking about how do we do cardiovascular risk stratification and assessment. I found out that we do this in a slightly different way, and I think you do it in the best way, so tell us how you do that in Hospital Saint-Louis.”
Jean-Jacques Kiladjian: “I’m not sure it’s better, but, yeah, it’s different. Well, we have a quite aggressive and proactive attitude regarding cardiovascular assessment of all patients with PV regardless of age. Obviously the older they are, they’re usually already followed by a cardiologist sometimes or they already had some cardiovascular events.
But even in younger patients with absolutely no history of cardiovascular events, we frequently refer them to a cardiologist, not any cardiologist, but a cardiologist that knows what we are looking for, that these patients are at high risk of cardiovascular problems in the future, that they will be followed for decades and we need this proper assessment.
At least an echocardiogram, doppler of arteries, peripheral arteries, is performed. We ask to perform that for almost every patient at baseline and then regularly every 2 to 3 years in patients without any risk factors, more frequently if needed. So yes, we have a quite very proactive attitude against these additional factors because we also noticed that—and maybe this is a field for the future as Alessandro said—that it’s not exactly maybe the same risk factors for arterial versus venous thrombotic events.
Maybe some characteristics of the disease, of the patients, may predispose more to arterial events that are more dangerous for the patients like myocardial infarction, stroke, et cetera, and these risk factors may be different. And the cardiovascular, let’s say landscape of the patient at baseline is very important to avoid and to prevent these arterial events.”
The full presentation with transcript is available HERE.