LOUIS—Monoclonal gammopathy of undetermined significance (MGUS) is not considered a hematological condition of concern, yet it is associated with lower overall survival. VA researchers led by Lawrence Liu, MD, of the St. Louis VAMC, explored whether the reduced life expectancy arose from an increased risk of cardiovascular events.
MGUS is a noncancerous hematological disorder in which the body produces an abnormal protein. In the U.S., individuals diagnosed with MGUS have a median survival of 8.1 years compared to 11.8 years for those without the diagnosis. Other studies have found a that MGUS patients have twice the mortality rate of the general population.1
In a study presented at the 65th American Society of Hematology Annual Meeting in San Diego in December 2023, the team found that MGUS was indeed associated with an increased risk of cardiovascular disease (CVD) in veterans 50 years of age and older.2
The team, which included clinicians from the Durham VAMC and the VA’s National Oncology Program as well several from the St. Louis VAMC, tracked a cohort of 523,098 veterans aged 50 or older without cardiovascular disease-related events until they developed CVD, death or Dec. 31, 2022.
Of the cohort, 20,506 received a diagnosis of MGUS during the study period and 40% of them developed cardiovascular disease compared to 25.4% of the 503,098 who did not develop MGUS. The cardiovascular disease events included 18.6% with heart failure in the MGUS group and 8.7% in the non-MGUS group.
Veterans with MGUS were more likely to be male (95.5%) compared to those without MGUS (86.5%), non-Hispanic Black (29.7% vs. 22.0%) and non-Hispanic white (55.2% versus 50%). Veterans with MGUS were also nearly twice as likely to be divorced, separated, widowed or single and were more likely to have diabetes mellitus (38.4% versus 22.0%).
Overall, MGUS increased the odds of having cardiovascular disease by 23% (95% CI: 1.19-1.26).
Liu L, Pant N, Wang M, Grandhi N, Proskuriakova E, Janakiram M, Thomas T, Sanfilippo KM, Colditz G, Friedman DR, Schoen MW, Change SH. Monoclonal Gammopathy of Undetermined Significance and Risk of Cardiovascular Disease in US Veterans. Abstract 4773. ASH 2023. December 11, 2023.
The researchers concluded that “MGUS was associated with an increased risk of diagnosis of cardiovascular disease for individuals aged 50 years or older. Clinicians should consider evaluation of patients with MGUS for CVD risk factors. Further studies are required to evaluate whether addressing modifiable CVD risk factors is associated with decreased risk of developing CVD in MGUS patients.”
1Kristinsson SY, Björkholm M, Andersson TM, Eloranta S, Dickman PW, Goldin LR, Blimark C, Mellqvist UH, Wahlin A, Turesson I, Landgren O. Patterns of survival and causes of death following a diagnosis of monoclonal gammopathy of undetermined significance: a population-based study. Haematologica. 2009 Dec;94(12):1714-20.
2Liu L, Pant N, Wang M, Grandhi N, Proskuriakova E, Janakiram M, Thomas T, Sanfilippo KM, Colditz G, Friedman DR, Schoen MW, Change SH. Monoclonal Gammopathy of Undetermined Significance and Risk of Cardiovascular Disease in US Veterans. Abstract 4773. ASH 2023. December 11, 2023.