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World J Cardiol. Nov 26, 2023; 15(11): 571-581
Published online Nov 26, 2023. doi: 10.4330/wjc.v15.i11.571
Acute myocardial infarction in myeloproliferative neoplasms
Muhammad Romail Manan, Vincent Kipkorir, Iqra Nawaz, Maryann Wanjiku Waithaka, Bahadar Singh Srichawla, Amelia Maria Găman, Camelia Cristina Diaconu, Mihnea-Alexandru Găman
Muhammad Romail Manan, Services Institute of Medical Sciences, Lahore 54000, Pakistan
Vincent Kipkorir, Maryann Wanjiku Waithaka, Department of Human Anatomy and Physiology, University of Nairobi, Nairobi 00100, Kenya
Iqra Nawaz, Quaid-e-Azam Medical College, Bahawalpur 63100, Pakistan
Bahadar Singh Srichawla, Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA 01655, United States
Amelia Maria Găman, Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, Craiova 200143, Romania
Amelia Maria Găman, Clinic of Hematology, Filantropia City Hospital, Craiova 200143, Romania
Camelia Cristina Diaconu, Department of Internal Medicine, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest 050474, Romania
Camelia Cristina Diaconu, Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest, Bucharest 105402, Romania
Mihnea-Alexandru Găman, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest 050474, Romania
Mihnea-Alexandru Găman, Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest 022328, Romania
Mihnea-Alexandru Găman, Department of Cellular and Molecular Pathology, Stefan S. Nicolau Institute of Virology, Romanian Academy, Bucharest 030304, Romania
Co-corresponding authors: Camelia Cristina Diaconu and Mihnea-Alexandru Găman.
Author contributions: Manan MR, Kipkorir V, Nawaz I, Waithaka MW, Srichawla BS, and Găman MA reviewed the literature and drafted the manuscript; Găman AM, Diaconu CC, and Găman MA provided overall intellectual input, reviewed the literature, and edited the final version of the manuscript and contributed equally as senior/last authors; and all authors approved the final version to be published. Găman MA and Diaconu CC are co-corresponding authors for this manuscript due to their significant contribution to the conceptualization, methodology, supervision, writing, review and editing. Găman MA is the corresponding author responsible for the communication with the journal.
Supported by the grant funded by Competitiveness Operational Programme A1.1.4. ID: P_37_798 MYELOAL-EDIAPROT, Grant Agreement no. 149/26.10.2016 (MySMIS2014+: 106774).
Conflict-of-interest statement: Dr. Găman reports grants from the Competitiveness Operational Programme A1.1.4. ID: P_37_798 MYELOAL-EDIAPROT, Grant Agreement no. 149/26.10.2016 (MySMIS2014+: 106774) during the conduct of the study; the other authors do not have any conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mihnea-Alexandru Găman, Doctor, MD, PhD, Doctor, Research Fellow, Researcher, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania. mihneagaman@yahoo.com
Received: August 14, 2023
Peer-review started: August 14, 2023
First decision: September 19, 2023
Revised: October 21, 2023
Accepted: November 13, 2023
Article in press: November 13, 2023
Published online: November 26, 2023
Abstract

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of hematologic malignancies characterized by an abnormal proliferation of cells of the myeloid lineage. Affected individuals are at increased risk for cardiovascular and thrombotic events. Myocardial infarction (MI) may be one of the earliest clinical manifestations of MPNs or may be a thrombotic complication that develops during the natural course of the disease. In the present review, we examine the epidemiology, pathogenesis, clinical presentation, and management of MI in MPNs based on the available literature. Moreover, we review potential biomarkers that could mediate the MI-MPNs crosstalk, from classical biochemical tests, e.g., lactate dehydrogenase, creatine kinase and troponins, to pro-inflammatory cytokines, oxidative stress markers, and clonal hematopoiesis.

Keywords: Myeloproliferative neoplasms, Polycythemia vera, Essential thrombocythemia, Myelofibrosis, Myocardial infarction, Acute coronary syndrome, Biomarker, Clonal hematopoiesis

Core Tip: Patients diagnosed with myeloproliferative neoplasms (MPNs) are at risk of developing thrombotic complications, among which acute coronary syndromes are of relevance. Myocardial infarction (MI) can emerge as the initial event in the diagnosis of MPNs or occurs during the evolution of the disease. Here, we examine the interplay between MI and MPN, with a focus on the epidemiology, presentation, risk factors, diagnosis, and management of MI in MPNs, as well as discuss potential biomarkers of MI in MPNs, as well as the role of inflammation and clonal hematopoiesis.