Infarto Agudo do Miocárdio como Primeira Manifestação da Policitemia Vera

Acute myocardial infarction in myeloproliferative neoplasms

“…PV is diagnosed when the three main criteria are met, or when the patients meet the first two main criteria and the minor criterion defined by the WHO[ 3 ]. The main criteria for PV issued by the WHO include: (1) Hemoglobin level > 16.5 g/dL in males, and > 16.0 g/dL in women or a hematocrit > 49% in males and > 48% in women or increased red cell mass; (2) Hypercellularity for age with trilinear growth observed on bone marrow biopsy; (3) Detection of JAK2 mutations (V617F or exon 12 mutations).…”

“…The main criteria for PV issued by the WHO include: (1) Hemoglobin level > 16.5 g/dL in males, and > 16.0 g/dL in women or a hematocrit > 49% in males and > 48% in women or increased red cell mass; (2) Hypercellularity for age with trilinear growth observed on bone marrow biopsy; (3) Detection of JAK2 mutations (V617F or exon 12 mutations). The minor criterion includes a decreased serum erythropoietin level[ 3 ]. In patients with PMF, circulating platelets exhibit an activated state and demonstrate notably elevated levels of protein kinase Cepsilon (PKCepsilon)[ 41 ].…”

“…Furthermore, chronic neutrophilic leukemia, chronic eosinophilic leukemia, and unclassified MPN are also included in the classification presented by the World Health Organization (WHO)[ 1 ]. Among these, PV (characterized by an absolute increase in erythrocytes due to the proliferation of the erythroid lineage[ 3 ]), ET (marked by the excessive proliferation of hyperlobulated mature megakaryocytes in the bone marrow along with persistent peripheral blood thrombocytosis[ 4 ]) and PMF (characterized by abnormal differentiation of the megakaryocytic clone, ultimately resulting in excessive proliferation of reactive fibroblasts and fibrosis[ 5 ]) are BCR-ABL1 negative and will remain the focus of this review. The major cause of morbidity and mortality in MPNs are thrombo-hemorrhagic complications.…”

“…In patients diagnosed with ET, the incidence of thrombosis was reported to be 25%, with arterial thrombosis occurring more frequently than venous thrombosis[ 8 ]. During the follow-up of patients with PV, over a 10-year period, coronary events were frequently observed, with a reported rate of 11.4%[ 3 ]. Among a total of 1213 PV patients, thrombosis was identified in 19% of cases over a 20-year period, with 21.7% thrombotic events resulting in myocardial infarction (MI)[ 9 ].…”