弥散性血管内凝血（DIC）是所有白血病亚型的常见并发症，但它是急性髓系白血病（AML）的一个特别突出的特征。 DIC并发AML可导致多种并发症，但其与急性心血管并发症的关联此前尚未见报道。使用国家住院患者样本数据库获取AML个体，并使用ICD-10-DM收集基线人口统计学和合并症代码。患者被分为患有和不患有 DIC 的患者。使用 R 进行贪婪倾向匹配，以 1:1 的比例匹配两个队列的年龄、性别和 15 种其他基线合并症。使用赛前和赛后单变量分析以及赛后二元逻辑回归分析来分析结果。在总共 37,344 名 AML 患者中，996 名患有 DIC。 DIC 患者较年轻，主要是男性，并且基线心血管合并症的患病率较低。 DIC 患者的死亡率（30.2% vs 7.8%）、急性心肌梗塞（5.1% vs 1.8%）、急性肺水肿（2.3% vs 0.7%）、心脏骤停（6.4% vs 0.9%）和急性 DVT 具有统计学意义。 /PE（6.6% vs 2.7%）。匹配后的逻辑回归模型显示出相似的结果，但 DIC 患者的急性心力衰竭发生率显着较高。这些发现强调了密切心血管监测和及时识别 AML 合并 DIC 患者并发症的重要性。潜在的机制涉及促凝血因子、细胞因子释放和内皮功能障碍之间复杂的相互作用。需要进一步研究来制定有针对性的干预措施来预防和管理这些并发症。版权所有 © 2024 Elsevier Ltd。保留所有权利。

Disseminated intravascular coagulation (DIC) is a common complication of all leukemia subtypes, but it is an especially prominent feature of Acute Myeloid Leukemias (AML). DIC complicating AML can lead to a variety of complications, however, its association with acute cardiovascular complications has not been reported before.National Inpatient Sample Database was used to procure individuals with AML, and baseline demographics and comorbidities were collected using ICD-10-DM codes. Patients were stratified into those with and without DIC. Greedy propensity matching using R was performed to match the two cohorts in 1:1 ratio on age, gender, and fifteen other baseline comorbidities. Univariate analysis pre and post-match along with binary logistic regression analysis post-match were used to analyze outcomes.Out of a total of 37,344 patients with AML, 996 had DIC. DIC patients were younger, predominantly males, and had lower prevalence of baseline cardiovascular comorbidities. DIC patients had statistically significant higher mortality (30.2 % vs 7.8 %), acute myocardial infarction (5.1 % vs 1.8 %), acute pulmonary edema (2.3 % vs 0.7 %), cardiac arrest (6.4 % vs 0.9 %), and acute DVT/PE (6.6 % vs 2.7 %). Logistic regression model after matching showed similar outcomes along with significantly higher rates of acute heart failure in DIC patients.These findings highlight the importance of close cardiovascular monitoring and prompt recognition of complications in AML patients with DIC. The underlying mechanisms involve a complex interplay of procoagulant factors, cytokine release, and endothelial dysfunction. Further studies are needed to develop targeted interventions for prevention and management of these complications.Copyright © 2024 Elsevier Ltd. All rights reserved.