Various factors, including the lactate dehydrogenase (LDH) ratio, can predict risk for thromboembolic events (TE) in people with paroxysmal nocturnal hemoglobinuria (PNH), according to results published in Annals of Hematology. Jong- Wook Lee, MD, PhD, and colleagues matched patients with PNH and a history of one or more TEs with up to five patients with no TE. They conducted multivariable analyses with the following variables: percentage of glycosylphosphatidylinositol (GPI)-negative cells, high disease activity (had), non-TE major adverse vascular event history, and recent anticoagulation. The study included 57 patients with TE and 189 matched controls. The following factors were associated with higher thrombotic risk: history of TE (with recent anticoagulation: OR, 8.91; 95% CI, 0.86-92.62; without recent anticoagulation: OR, 5.33; 95% CI, 0.26-109.57), a GPI-negative granulocyte percentage of 30% or higher (≥30% to <50%: OR, 4.94; 95% CI, 0.54-45.32; ≥50%: OR, 1.97; 95% CI, 0.45-8.55), and an LDH ratio greater than or equal to 1.5 times the upper limit of normal plus two or more high disease activity criteria (2-3 criteria: OR, 3.18; 95% CI, 0.44- 23.20; ≥4 criteria: OR, 3.60; 95% CI, 0.38- 33.95). “These findings will aid physicians by providing important clinical and laboratory risk factors that can be used to identify and manage patients with PNH who are at risk of developing TE,” Dr. Lee and colleagues wrote.”
