Publication Date
9-14-2023
Journal
Journal of Clinical Medicine
DOI
10.3390/jcm12185961
PMID
37762903
PMCID
PMC10531888
Published Open-Access
no
Keywords
TTP, TMA, cardiovascular disease, stroke
Abstract
Advances in the management of immune thrombotic thrombocytopenic purpura (iTTP) have dramatically improved outcomes of acute TTP episodes, and TTP is now treated as a chronic, relapsing disorder. It is now recognized that iTTP survivors are at high risk for vascular disease, with stroke and myocardial infarction occurring at younger ages than in the general population, and cardiovascular disease is the leading cause of premature death in this population. iTTP appears to have a phenotype of accelerated vascular aging with a particular predilection for cerebral circulation, and stroke is much more common than myocardial infarction. In addition to traditional cardiovascular risk factors, low ADAMTS13 activity during clinical remission may be a risk factor for some of these outcomes, such as stroke. Recent studies also suggest that Black patients, who are disproportionately affected by iTTP in the United States, are at higher risk of adverse cardiovascular outcomes, likely due to multifactorial reasons. Additional research is required to establish the risk factors and mechanisms underlying these complications in order to institute optimal screening strategies and identify interventions to improve outcomes.
Included in
Cardiology Commons, Cardiovascular Diseases Commons, Medical Sciences Commons, Neoplasms Commons, Oncology Commons
Comments
Associated Data