Abstract 790: Effect of heart failure on incidence rates of pneumonia, septic shock and overall mortality in patients with myelodysplastic syndrome

Abstract Introduction: Myelodysplastic syndromes (MDS) refer to disorders originating from clonal stem cells, marked by ineffective hemopoiesis and cytopenias. Patients with MDS have a higher incidence of cardiovascular mortality, with heart failure playing a significant role. This has been linked to persistent anemia, excess iron accumulation and a systemic inflammatory state. Patients with MDS have significantly higher rates of infectious events, with pneumonia (PNA) and sepsis being the most common infections. The influence of systolic heart failure (SHF) or diastolic heart failure (DHF) on the risk of infections in patients with MDS is unclear. We evaluated whether chronic SHF or DHF, as well as acute SHF or DHF in concomitance with MDS, affected the rates of PNA, septic shock and overall mortality. Method: A retrospective study identified patients with MDS using specific ICD 10 codes (D46.9, D46A-C and D46.22) from the National Inpatient Sample 2019-2021. Patients with acute and chronic SHF or DHF were obtained using particular ICD 10 codes (I50.2 - I50.4). The incidence rates of PNA, septic shock and overall mortality were compared between MDS patients with each of these types of HFs versus those without any HF using multivariate logistic regression adjusting for demographic characteristics, hospital-related factors, and common comorbidities. Results: A total of 223,975 patients were identified with MDS. Patients with MDS who had chronic SHF (n=11,505) showed increased rates of PNA (OR:1.4, p<0.001) and septic shock (OR: 1.4, p <0.001) but no significant difference in overall mortality (p=0.603) compared to those without any HF. Patients with MDS and acute SHF (n=12,560) had enhanced rates of PNA (OR: 1.4, p<0.001), septic shock (OR: 1.9, p<0.001), and overall mortality (OR:1.6, p<0.001) versus those without any HF. Patients with MDS and chronic DHF (n=18,990) had no difference in rates of PNA (p=0.2), septic shock (p=0.16), or overall mortality (p=0.1). Acute DHF (n=16,700) led to a greater incidence of PNA (OR: 1.5, p<0.001) and overall mortality (OR: 1.2, p<0.001), but no significant difference in the incidence of septic shock (p=0.07) in patients with MDS. Conclusion: Acute SHF was associated with significantly elevated rates of PNA and septic shock in patients with MDS, whereas acute DHF was linked to an increased incidence of PNA. Chronic SHF demonstrated higher occurrences of both PNA and septic shock. Furthermore, acute SHF and DHF correlated with increased mortality rates. Consequently, fostering early collaboration between hematology specialists and those in cardio-oncology is essential for effectively managing patients who have both MDS and HF. This would enable the implementation of timely preventive measures and therapeutic interventions, leading to more comprehensive care strategies that may improve clinical outcomes for these patients. Citation Format: Karnav Modi, Himil Mahadevia, Simran Chandra, Ibrahim Khamees, Parth Sharma, Deepthi Vodnala, Taiyeb Khumri. Effect of heart failure on incidence rates of pneumonia, septic shock and overall mortality in patients with myelodysplastic syndrome [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 790.