Ruxolitinib and heart failure outcomes among patients with myelofibrosis

Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis. Patients with MF are at increased risk of heart failure (HF) and pulmonary hypertension (PH), which are associated with morbidity and mortality. Ruxolitinib is used in MF to palliate symptom. Whether treatment with ruxolitinib impacts risk of HF hospitalization or new PH in MF is unknown. This was a retrospective cohort of MF patients without prior HF. Outcomes were HF hospitalization or new PH and all-cause death. A total of 144 patients were included, 46 (31.9%) were on ruxolitinib, 40.3% were female and 78.5% were White race. Ruxolitinib treatment was associated with lower risk of HF hospitalization or new PH (adjusted subhazard ratio 0.27, 95% CI 0.10-0.73) but not all-cause death (adjusted HR 0.85, 95% CI 0.42-1.72). Prospective, randomized studies are needed to confirm the impact of ruxolitinib on cardiovascular outcomes among patients with MF.