From the Guidelines
The risk of stroke or myocardial infarction in an untreated female patient with Essential Thrombocythemia (ET) is approximately 1% per year, as the majority of patients are classified as low-risk and do not exhibit thrombotic events. This risk varies based on individual risk factors, with higher rates in those over 60 years of age, those with prior thrombotic events, or those with cardiovascular risk factors such as hypertension, diabetes, or smoking 1.
Risk Factors
- Age: patients over 60 years have a higher risk of thrombotic events
- Prior thrombotic events: patients with a history of thrombosis are at higher risk
- Cardiovascular risk factors: hypertension, diabetes, and smoking increase the risk of thrombotic events
- JAK2 mutation: presence of JAK2 mutation increases the risk of thrombotic events
Management
For female patients with ET, risk assessment is crucial, and treatment typically involves low-dose aspirin (81-100mg daily) for low-risk patients, while cytoreductive therapy with hydroxyurea, anagrelide, or interferon may be necessary for high-risk patients 1.
Monitoring
Regular monitoring of platelet counts, symptoms, and cardiovascular health is essential for managing this chronic myeloproliferative neoplasm effectively. The revised International Prognostic Score of Thrombosis for ET (IPSET-Thrombosis) is preferred for the risk stratification of ET 1.
Treatment
Low-dose aspirin is recommended for patients with low-risk ET, while cytoreductive therapy may be necessary for high-risk patients. However, the use of low-dose aspirin may not be beneficial in patients with low-risk CALR-mutated ET, although there is not enough evidence to recommend withholding aspirin for this group of patients 1.
From the Research
Risk of Stroke or Myocardial Infarction in Untreated Female Patients with Essential Thrombocythemia (ET)
- The risk of stroke or myocardial infarction in untreated female patients with Essential Thrombocythemia (ET) is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that patients with ET are at risk of thrombotic events, including stroke and myocardial infarction, due to abnormal megakaryopoiesis and platelet dysfunction 3, 6.
- The risk of thrombosis is higher in patients with ET who have a history of thrombosis, are older than 60 years, or have a JAK2 mutation 3, 4, 5.
- The studies do not provide a specific percentage risk of stroke or myocardial infarction in untreated female patients with ET, but they emphasize the importance of treatment to prevent thrombohemorrhagic complications 3, 4, 5.
- Treatment options for ET include antiplatelet therapy, such as low-dose aspirin, and cytoreductive therapy, such as hydroxyurea, to reduce the risk of thrombosis 3, 4, 5, 6.