Major vascular complications in essential thrombocythemia: a study of the predictive factors in a series of 148 patients

To determine the clinicohematological factors predictive for the appearance of major vascular complications (MVC) in patients with essential thrombocy themia (ET), 148 consecutive such patients were retrospectively assessed fo r the development of MVC during a median follow-up of 58.5 months. Seventy- seven patients had vascular risk factors, and 37 a history of MVC at ET dia gnosis. Forty-nine MVC were registered in 33 patients during the follow-up period. The actuarial probability of MVC was 27% at 6 years in the whole se ries, 35.6% for patients above 60 years, and 21.4% for patients younger tha n 60 years, whereas only one of the 36 patients younger than 45 years had M VC. At multivariate analysis, age >60 years, history of major ischemia and hypercholesterolemia were the variables associated with an increased MVC ri sk. These results suggest that all ET patients above 60 years should be tre ated, whereas in younger patients treatment decisions should be primarily b ased on the existence of risk factors for MVC.