الفهرس 
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Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal heamopoietic stem cell derived disorders characterized by ineffective hemopoiesis, cytopenias and a substantial risk of progression to acute myeloid leukemia.
Cardiovascular risk factors are non- modifiable (including age, sex and family history) and modifiable (including smoking, dyslipidemia, obesity, hypertension and DM). The mechanism by which all of these factors increase the cardiac risk is initiation of physical and functional changes in endothelial cells resulting in endothelial dysfunction which in turn lead to activation of an inflammatory process that ends in formation of atherosclerotic plaques and hence atherosclerosis.
Heamatological malignancies , specially MPNs and MDS, have a pathological connection with cardiovascular complications. MDS patients, compared with individuals without MDS from the general population, have 2 folds elevated risks of arterial cardiovascular events. Clonally derived cells in MDS carry several point mutations as TET2 & ASXL1. These mutations lead to activation of janus-associated kinase (JAK) which regulate production of proinflammatory cytokines involved in the process of atherosclerosis.
Carotid intima-media thickness (CIMT) is a non-invasive method to detect early subclinical atherosclerosis and it correlates well with overall vascular injury and extend and severity of coronary artery disease. CIMT ultrasonography may represent an accessible and reliable method to detect subclinical atherosclerosis so it predicts future cardiovascular and ischemic stroke incidence.
C-reactive protein (CRP) is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease, and recurrent events and death in patients with acute or stable coronary syndromes.
We aimed to evaluate Cardiovascular risk factors in elderly patients with MDS in addition to unravelling their possible correlation of CIMT with clinical, hematologic and laboratory variables and finally to find out if MDS is a risk factor for atherosclerosis.
In our study, we included 168 patients, 84 of them diagnosed as Myelodysplastic syndromes (MDS), we selected them from the outpatients and inpatients of Hematology department of Menoufia University Hospitals during the period from first March 2021 to the end of May 2023. We compared the selected MDS patients to controls of 84 normal persons matched by age and gender.
10 ml blood sample using EDTA as an anticoagulant was collected from each participant after fasting 12 hours from peripheral veins. After that, serum centrifugation at 1800g under 4 °C for 15 min was done and biochemical tests were performed.
Carotid artery intima media thickness (CIMT) by duplex ultrasound using GE logic E10 United states device.
There was significant difference between cases and controls regarding levels of total cholesterol, LDL, triglycerides, FBS, 2h-PPG, SBP, Hs-CRP, Rt. CIMT & Lt. CIMT. However, there was a difference between the groups regarding homocysteine but of no significance.
There was significant positive correlation between CIMT and the following parameters: Cholesterol level (mg/dl), TG level (mg/dl), HOMA-IR, CRP (mg/l) & TLC.
Our study was limited by:
- Age and number of patients, as we excluded all individuals below 55y - Cytogenic and Molecular analysis were not available