DP125 | QRISK3 SCORE IS PREDICTIVE OF THROMBOTIC RISK IN PATIENTS WITH MYELOPROLIFERATIVE NEOPLASMS

BACKGROUND Thromboembolic events represent a common cause of morbidity and mortality in myeloproliferative neoplasms (MPN). Cardiovascular risk factors are not actually incorporated in most prognostic tools when stratifying patients for thrombotic risk. The QRISK3 model was designed to estimate an individual’s risk of experiencing a cardiovascular event, combining clinical and demographic variables. AIMS AND METHODS We retrospectively reviewed the use of the QRISK3 score to assess cardiovascular risk, aiming to identify patients stratified as low-risk for TE, who may benefit from cytoreductive intervention. The QRISK3 score was evaluated using a web tool (https://qrisk.org/index.php). Patients were stratified firstly according to standard classification, then considering QRISK3 score, to identify a threshold at diagnosis and during follow-up that might predict further TE risk. A QRISK3 score of ≥7.5% risk for TE was used to stratify low and high-risk patients. RESULTS We analyzed the data of 937 patients (490 ET and 447 PV) with a median follow-up of 85 and 95 months, reporting 52 and 73 TE occurrences, respectively. The QRISK3 scores calculated at diagnosis were higher in conventional high-risk patients in both cohorts (4.2 vs. 2.4 for ET high vs low-risk, and 8.8 vs. 2.8 for PV, p<0.001). 118 (24.1%) ET patients and 112 (25.1%) PV patients had a QRISK3 score ≥7.5%, confirmed by best threshold by ROC. In the ET cohort, 25.4% of patients with QRISK3 ≥7.5% experienced a TE during follow-up. Traditional cardiovascular risk factors were not significantly linked to increased TE risk, but older age was (median 58 vs. 45 years, p=0.001). Cytoreductive treatment significantly reduced thrombosis risk, with 80.1% of treated patients remaining thrombosis-free, compared to 60% of untreated patients (p=0.029). In the PV cohort, 24.1% with QRISK3 ≥7.5% had TE, with age being a key risk factor (67 vs. 60 years, p<0.001). Other cardiovascular risk factors showed no significant impact. Cytoreductive therapy was protective, with 85.9% of treated patients remaining thrombosis-free versus 55.6% of those untreated (p=0.002). QRISK3 enhances risk stratification for thromboembolic events in ET and PV, outperforming standard risk models, thus splitting the patients adequately (Figure 1, p<0.001). CONCLUSIONS We demonstrate that QRISK3 allows additional cardiovascular risk factors to be assessed, identifying patients in whom disease-modifying therapies may be indicated.