In a retrospective single-center cohort of 214 patients with newly diagnosed AML treated with venetoclax-based therapy, 14 patients (6.5%) had major adverse cardiac events during active treatment. The study found risk was markedly higher in non-de novo AML than de novo AML (85.7% vs. 14.3%; subdistribution HR 7.1, 95% CI 1.5-33), making cardiac surveillance especially relevant in secondary or treatment-related disease.

Why It Matters To Your Practice

• Venetoclax-based regimens in newly diagnosed AML carried a measurable risk of major cardiac events, including new-onset heart failure, heart failure exacerbation requiring hospitalization, myocardial infarction/coronary revascularization, and stroke/TIA.

• The cohort was older (mean age 71.5 years), which mirrors many real-world AML patients seen by NPs and PAs.

• Heart disease risk may be particularly important to flag early in patients with secondary or treatment-related AML.

Clinical Benefits

• This study helps quantify cardiac risk during venetoclax treatment, giving clinicians a clearer basis for counseling patients and caregivers.

• Knowing that 6.5% experienced MACE can support baseline cardiovascular review and symptom monitoring plans.

• Higher-risk identification may help prioritize closer follow-up for patients with non-de novo AML.

Managing Risks

• Review baseline cardiovascular history, prior heart failure, ischemic disease, cerebrovascular history, and current cardiology medications before and during therapy.

• Monitor for dyspnea, edema, chest pain, neurologic deficits, and other interval symptoms that could signal MACE while patients are on active venetoclax-based treatment.

• Consider earlier escalation or multidisciplinary input when patients have secondary/treatment-related AML or develop new cardiopulmonary or neurologic symptoms.

The Bottom Line

• Major cardiac events occurred in 6.5% of patients with newly diagnosed AML receiving venetoclax-based therapy.

• The highest risk was seen in secondary or treatment-related AML, underscoring the need for practical cardiac vigilance in routine oncology care.